eheadspace Group Chat
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Group Chat
Helping your young person when they have experienced trauma
September 11th 2018 @ 12am AEST
Many parents and other adults supporting young people are concerned for a young person who has experienced trauma of some kind. It can be hard to know how best to help and trauma can have serious impacts on a young person’s development. Improving your understanding and skills in this area could be a key protective factor for your young person.
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eheadspace
Moderator
7 Dec. 12:53 pm
eheadspaceMich Hi everyone and welcome to our Group Chat session today for parents and other adults supporting young people! Today we hope we can offer you the chance to ask questions, share with each other helpful ideas and generally find some more support for yourselves in assisting young people you care about. We’ll respond to your questions and add some comments and resources as well. We have a range of mental health professionals in our session today. My name is Mich. I am a family therapist, and we have Di and Alana who are mental health clinicians with a lot of experience in mental health and trauma, and Anthony who is an advisor with our schools program who has had significant leadership experience in schools on our team tonight. We’re ready to respond to your comments and questions.
eheadspace
Moderator
7 Dec. 12:53 pm
eheadspaceMich From our Family reference group we have Ann joining us tonight. And we have Kimberley joining us from our headspace National Youth Reference Group today. Many thanks to both of you. We look forward to your contributions!
eheadspace
Moderator
7 Dec. 1:05 pm
eheadspaceMich Sometimes it takes a bit of time for us to respond – so please hang in there. We try to give your questions some thought and hopefully make our responses useful to you. A couple of things before you start chatting • When you submit your question it won't appear straight away • Our team will be busy reading and preparing an answer to your question before it is posted live - we appreciate your patience • If we can't publish anything we'll let you know • It also helps if you use a name (even if it's not your own!) so if you have a follow up questions we know who we're talking to. Also, if you don’t use a name all your responses come in from ‘Guest’ so that can be confusing for us! Thanks in advance to everyone participating : )
eheadspace
Moderator
7 Dec. 1:05 pm
eheadspaceMich And just to say, don't worry if you feel this is moving on too quickly for you to read everything! The page jumps ahead when we post material. But it will all be available on our website from this page from later today or tomorrow. This content stays on our website for quite a while too....https://eheadspace.org.au/get-help/past-live-info-sessions/
eheadspace
Moderator
7 Dec. 1:06 pm
Di eheadspace Hello welcome to the chat
Anonymous 9587
Participant
7 Dec. 1:06 pm
Comment From Guest Hi all!
Anonymous 9587
Participant
7 Dec. 1:06 pm
Comment From Kimberley (hYNRG) Hello and welcome everyone! :)
Anonymous 9587
Participant
7 Dec. 1:06 pm
SchoolsAnthony Hi and welcome Kimberly, thanks for joining us!
Anonymous 9587
Participant
7 Dec. 1:06 pm
Hi everyone! It's great to be able to chat with you all about this important topic.
Anonymous 9587
Participant
7 Dec. 1:06 pm
Comment From Michelle Hi
Anonymous 9587
Participant
7 Dec. 1:07 pm
Comment From AnnFAF hi Everyone. I am from the Family and Friends Reference group
eheadspace
Moderator
7 Dec. 1:07 pm
eheadspaceMich Hi everyone While you're sending in your questions we will post some material on the topic and our team will be responding to you...
eheadspace
Moderator
7 Dec. 1:07 pm
eheadspaceMich Introduction: • Trauma is a very broad term. • Experience of trauma is very common • We are offering some information on trauma and resources and responding to questions but it’s often important to get individual help which can take into account the particular circumstances • Knowledge, understanding and approach to trauma has been variable over time. Some experiences that have been traumatic have been in some ways ‘disallowed’ or misunderstood. • Self-care is key for anyone who has experienced trauma and anyone supporting them, whether personally or professionally.
Anonymous 9587
Participant
7 Dec. 1:08 pm
Comment From Guest Hi
eheadspace
Moderator
7 Dec. 1:08 pm
eheadspaceMich What is Trauma? Any event that involves exposure to actual or threatened death, serious injury, or sexual violence has the potential to be traumatic. Almost everyone who experiences trauma will be emotionally affected, but not everyone will respond in the same way. Most people will recover within the first week or two with the help of family and friends. For some, the effects can be long lasting. Traumatic events can include: • experiencing a serious accident, a physical assault, war, a natural disaster, sexual assault or abuse • witnessing these events happening to another person • learning that a friend or family member died suddenly (e.g., as a result of an assault or an accident), was involved in a life threatening event, or was seriously injured. Trauma can result in: • Changes to the brain • Compromised immune systems • Increased physical and mental stress • Decreased trust • Attachment difficulties and conflictual relationships • Hyperarousal and hypervigilance • Rigid or chaotic behaviour
eheadspace
Moderator
7 Dec. 1:08 pm
eheadspaceMich Trauma and communities Trauma can affect whole communities and naturally if a whole community is affected this can make recover harder for individuals. Some examples include Aboriginal communities affected by dislocation from their lands and child removal, refugee groups experiencing war, people affected by the Holocaust and other genocides in history.
eheadspace
Moderator
7 Dec. 1:08 pm
eheadspaceMich Self-Care • Self-care – this is something we always refer to in our sessions but in relation to this topic we think it needs to be mentioned early. • This is because learning and practicing self-care will be helpful for you *in general, *helpful as an example to your young person and *helpful in supporting you to maintain the calm and as unstressed as possible approach to your young person which is key. • We can all help each other by working on managing our own stress and internal reactions. Think about the reverse – if someone you’re close to becomes anxious it can almost feel ‘contagious’ and you might find yourself become anxious as well. This mutual influence we have with each other can be significant. Good self-care can positively interrupt those stressful and difficult influences.
Anonymous 9587
Participant
7 Dec. 1:09 pm
Comment From Annoy How do you get a young person to open up after a death in the family that was sudden? I’ve tried everything but it hasn’t work and tis young persons school life is now effected
eheadspace
Moderator
7 Dec. 1:09 pm
Hi there Annoy. Sorry to hear about the death in your family. It's certainly understandable wanting your young person to get the right support. It is quite common for parents and other adults to experience difficulty in encouraging young people to open up about things. What you could try is to let the young person know you are concerned about them, and why - actually describe to them what you're noticing, that you are concerned, and that 'the door is always open' - that they can talk to you, their school counsellor, another family member, etc. Then they can come to you (or someone else they feel comfortable talking to), in their own time.
Anonymous 9587
Participant
7 Dec. 1:09 pm
Comment From Pete We have a student at our school from a refugee background. He is doing pretty well, but we are aware that things at breaks are not always going well. He is getting into fights with other students and they feel he’s over-reacting. Is there anything we can do to improve the situation?
eheadspace
Moderator
7 Dec. 1:09 pm
SchoolsAnthony Hi Pete, It’s great that you’re thinking about this student and looking for ways to help him and improve the situation! One idea you might consider is introducing peer mediation training at the school so students in general learn to problem solve and manage conflicts. This also has the advantage that you are not only focussing on this individual student and you’re hopefully giving them all some new skills and ways to handle things more constructively. Perhaps a teacher he is close to could check in with the student and/or he might benefit from some calm and really practical suggestions for managing breaks. Some students benefit from ‘coaching’ where you run through a bit of a role play, practice skills, learn some ways to respond to challenging situations. Sometimes problems arise when students are bored. See if you can introduce some more interesting activities or games at break times. Engaging the young person in a team sport may also assist to build mutual understanding and trust with his peers. Help for this student from a school counsellor might also be helpful too.
eheadspace
Moderator
7 Dec. 1:10 pm
eheadspaceMich We have quite a bit of content to post tonight as it's a big topic. But again, you can check back and read it later if you miss it while it's live! Trauma can arise from single or repeated adverse events that threaten to overwhelm a person’s ability to cope. When it is repeated and extreme, occurs over a long time, or is perpetrated in childhood by care-givers it is called complex trauma. (later in our session today we have some more material on complex trauma to post) • Two thirds of people presenting to mental health services, have experienced child physical or sexual abuse. Other causes of complex trauma include emotional abuse, neglect, family violence, living with a parent with a mental illness or who abuses substances, war and refugee trauma, separation and loss. In Australia 5 million adults have been affected by childhood trauma. • Many trauma survivors show remarkable resilience. However many are left struggling day to day with their health, wellbeing, emotions, relationships, and sense of self and identity. • Research has established that trauma is a major public health problem. Yet within current systems it is frequently unrecognised, unacknowledged, and unaddressed. More research is needed to explore whether different trauma-informed approaches are required for different population groups. • Traumatic events are often overwhelming. This can make it hard for people who have been through a traumatic event to think through and come to terms with what has happened. The experience is likely to be very different from anything they have gone through before. It can be hard to make sense of what happened, and sometimes it makes people doubt things that they’ve always believed. For instance, after a traumatic event a person might no longer believe that the world is a safe place, that people are generally good, or that they are in control of what happens to them. When people talk about their world being shattered after a traumatic event, they are usually talking about these beliefs being shattered. • Other stressful events, like relationship breakdowns or the loss of a loved one through natural causes, are difficult to go through and can affect a person’s mental health, but aren’t thought of as being traumatic in the same way as the events described above. This is important, because the treatment that is recommended to help people recover from trauma is different from recommended approaches to mental health problems arising from other stressful life events.
Anonymous 9587
Participant
7 Dec. 1:10 pm
Comment From Kimberley (hYNRG) Hi Annoy, that sounds like a really challenging situation and it is great you are trying to show you care. Sometimes after a sad event, we can process things in a way that does not make sense to those around us. It's possible your young person may just need time, and in the mean time you can show you care through non-verbal gestures such as favourite meals, hugs, or what ever your young person usually appreciates. School can also be a very difficult environment after the death of a loved one, and your young person may not know how to talk to their teachers or friends about what happened. Maybe you could see if the school could support your young person in anyway?
eheadspace
Moderator
7 Dec. 1:10 pm
eheadspaceMich Thanks Kimberley It's great to have your comments and that's a good idea to see how the school might be able to help
eheadspace
Moderator
7 Dec. 1:10 pm
eheadspaceMich Thanks everyone for your questions! We're working on our responses : )
eheadspace
Moderator
7 Dec. 1:11 pm
eheadspace
Moderator
7 Dec. 1:12 pm
eheadspace
Moderator
7 Dec. 1:12 pm
eheadspaceMich Dissociation • Dissociation is a mental process where a person disconnects from their thoughts, feelings, memories or sense of identity. People who experience a traumatic event will often have some degree of dissociation during the event itself or in the following hours, days or weeks. For example, the event seems ‘unreal’ or the person feels detached from what’s going on around them as if watching the events on television. • In most cases, the dissociation resolves without the need for treatment. • Some people, however, develop a dissociative disorder that requires treatment. Dissociative disorders are complex problems that need specific diagnosis, treatment and support. If you are concerned that you or a loved one may have a dissociative disorder, it is important to seek professional help. Symptoms and signs of dissociative disorders depend on the type and severity, but may include: • Feeling disconnected from yourself • Problems with handling intense emotions • Sudden and unexpected shifts in mood – for example, feeling very sad for no reason • Depression or anxiety problems, or both • Feeling as though the world is distorted or not real (called ‘derealisation’) • Memory problems that aren’t linked to physical injury or medical conditions • Other cognitive (thought-related) problems such as concentration problems • Significant memory lapses such as forgetting important personal information • Feeling compelled to behave in a certain way • Identity confusion – eg behaving in a way that the person would normally find abhorrent. For more information see this link and our other resources later in the session: https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/dissociation-and-dissociative-disorders
eheadspace
Moderator
7 Dec. 1:13 pm
eheadspaceMich Ann and Kimberley have you got any good self-care tips you'd like to share with us?
eheadspace
Moderator
7 Dec. 1:13 pm
eheadspaceMich Impact of trauma on the brain – new and emerging research and responses. (We have a couple of videos and illustrations to explain a little more about what we know about the brain and the impact of trauma on the brain.) • Memory and focus can be affected by trauma and a range of other functions
Anonymous 9587
Participant
7 Dec. 1:13 pm
Comment From AnnFAF I am someone who uses meditation for self care and recommend it highly, there is various forms of it, such as breathing walking in nature, colouring in. Also having a good network of support yourself is very important
Anonymous 9587
Participant
7 Dec. 1:13 pm
eheadspaceMich Thanks Ann, they are all good ideas. You've reminded me too that we have a couple of mandalas to post!
Anonymous 9587
Participant
7 Dec. 1:13 pm
Comment From Jessika Hello, after experiencing trauma ( sudden death) a teen has stopped talking, I’m not sure how to help her?
eheadspace
Moderator
7 Dec. 1:13 pm
eheadspaceAlana Jessika, sometimes when people experience a trauma, they can shut down. It's like their nervous system has gone into shock. They may also be grieving and don't know how to articulate their feelings. Your teen friend may have lots of questions going on in her head, or may even think there is some way she could have prevented the death, if she was close to the person who died. You could encourage her to write or draw her feelings. You could also make sure she knows about her school counsellor. Here are some other tips for helping someone who won't talk or seek help: • Let them know you love and care for them and that you find it hard to see them struggling • Gently explore any concerns they might have about talking or getting professional help, and keep the conversation non- blaming and as calm as possible • Involve other family or friends if you think the young person might be more willing to talk to them or accept their help • Offer help or suggestions if asked • Get informed about what help is available in your area so that you’ll be ready when they are more open to the idea. • Talk through how you’re feeling with someone. Look after yourself. Make sure you get some extra support and down time where possible. • Be honest about what you’re concerned about, in a calm way, and how you think talking could assist
eheadspace
Moderator
7 Dec. 1:13 pm
Anonymous 9587
Participant
7 Dec. 1:13 pm
Comment From Hannah I support a young person (13 years old) who has experienced complex trauma and has been diagnosed with PTSD as a result. She is really struggling lately, but has a lot of difficulty communicating about...pretty much anything, really. She takes a lot of her frustration and anger out on those around her, and it is taking a big toll on our whole family. Any tips about how to encourage/support communication? I've tried connecting with her verbally, offering for her to be able to send me messages or letters (she does this very occasionally) and have been working on upping our one-on-one time to try and build a sense of felt safety. She has started self-harming and talking about suicide in general. I have an appointment booked in for her with a psychologist on the 8th October, but I think she will attend the minimum 2-3 sessions we spoke about and then bail.
eheadspace
Moderator
7 Dec. 1:13 pm
Di eheadspace Hi Hannah, thanks for your question. It sounds like you are working really hard at supporting your young person. Yes it can be really difficult to know how things are going to go, there will often be times where you think things are moving forward then there will be a bump... I think from what you have already said to your young person about using different modes of communication using letters and messages keep having those conversations.... it is about letting them know that you are there.... Just to say that going slowly with your young person is very important. What you have described around anger are the ways of expressing her emotion ,as the words escpecially the emotional wordsd are really difficult to express or even understand, as you probably already know. Do you have have any options to bring the appointment forward. It sounds like you are doing an amazing job that is quiet complex. If you are concerned about the suicidal conversations that she is having that would be perhaps another reason to try and bring the appointment forward.. Hannah I would also suggest having a good look at the resources that will also be posted with our chat tonight. Just remember that if your young person is aware that you are there and support then no matter what that is the starting point. Please let me know if you want any further questions or a particular part of your question answered.
Anonymous 9587
Participant
7 Dec. 1:16 pm
Comment From Kimberley (hYNRG) I like to regularly reflect on the events of the day, and remember that other peoples actions aren't personal to me, but are instead caused by things they are experiencing or feeling. I also love to exercise, make a healthy meal, and watch or read something I enjoy for self care.
eheadspace
Moderator
7 Dec. 1:16 pm
eheadspaceMich What are `trauma-informed’ services? Trauma-informed services `are informed about, and sensitive to, trauma-related issues’. They do not directly treat trauma or the range of symptoms with which its different manifestations are associated. A trauma-informed service is one which: • Commits to and acts upon the principles of safety, trustworthiness, choice, collaboration and empowerment • Has reconsidered and evaluated all components of the system `in the light of a basic understanding of the role that violence plays in the lives of people seeking mental health and addictions services • Designs services that accommodate the vulnerabilities of trauma survivors and allows services to be delivered in a way that will avoid inadvertent re-traumatization and that facilitate consumer participation in treatment • Works hard to develop close and positive working relationships with other service systems
Anonymous 9587
Participant
7 Dec. 1:16 pm
Comment From AnnFAF In my experience it I refer back to an old saying I heard a long time to go. Listen to hear, not to help. I have found sometimes the young person just wants to be heard, without us having to find the solution for them, but our general instinct is to make it better
eheadspace
Moderator
7 Dec. 1:16 pm
eheadspaceMich What are `trauma-specific’ services? Trauma-specific services are designed to directly treat trauma experiences and related symptoms and syndromes, including with provision of `grounding techniques which help trauma survivors manage dissociative symptoms, desensitization therapies which help to render painful images more tolerable, and behavioural therapies which teach skills for the modulation of powerful emotions’. Trauma-specific services emphasise: • Client and worker safety, both physical and emotional • The importance of respect for clients, provision of information, possibilities for connection and instillation of hope • Recognition of symptoms as adaptive rather than pathological • Working with clients in a strengths based way • Trauma-specific services recognise the extent to which childhood trauma, abuse and neglect can lead to relational impairment, enduring fear, betrayal, and distrust. They operate from the premise that recovery needs to be assisted in a safe context • Effective trauma therapy, should attend to 1. Cognitive processing (thoughts, beliefs, interpretations, and other cognitions), 2. Emotional processing (emotion and affect), and 3. Sensorimotor processing (physical and sensory responses, sensations and movement’). • Key requirements of therapy for complex trauma – attunement to the relevant neurobiological processes, capacity to engage the right-brain, attentiveness to, and ways of working with, implicit memory, attentiveness to physical movement and the body as well as to talking, and phased treatment).
Anonymous 9587
Participant
7 Dec. 1:16 pm
Comment From Kimberley (hYNRG) Hi Jessika, you may already be trying this, but maybe think of some activities you could do with her in silence. These will allow you to be present with her, convey you care, and also provide her the opportunity to talk without pressure. Cooking, walking the dog, and creating art are some examples.
Anonymous 9587
Participant
7 Dec. 1:16 pm
Comment From Riccardo My son was close to another student at his school who committed suicide last week. My son is devastated and having nightmares. I’m so worried about him. Any ideas?
eheadspace
Moderator
7 Dec. 1:16 pm
SchoolsAnthony So sorry to hear about your son, Riccardo, and his friend. I imagine there are many others affected by this event. It’s hard as a parent hearing about something like this, isn’t it? It sounds like your son is letting you know at least some of what is going on for him, which is good to hear.Speaking to someone at his school, such as a Homeroom teacher/ Year Level Coordinator/ Head of House that your son is experiencing a difficult time to see if they have noticed any behaviours that may be cause for concern. You might want to check if the school has any support at the moment. For example, headspace in schools offers help to school communities at times like this. How is the school supporting your son? There are many good tip sheets from our headspace in Schools program available on this site – some for teachers, and parents and students. https://headspace.org.au/ Click on ‘School Support’ for more drop down menus. You might let your son know that it’s natural especially so close to an event like this to be experiencing things like nightmares. But if these things continue at the same intensity and don’t gradually decrease over time he might need some extra help.mg Not everyone needs ‘therapy’ after an event like this, but be aware that sometimes there are specific worries, memories or thoughts that can make it difficult to recover. For example, if your son is in any way feeling he contributed to the friend’s problems or wasn’t’ there to help him. As much as possible plan really good self-care with him, for him, for him with others.
eheadspace
Moderator
7 Dec. 1:16 pm
eheadspaceMich Practical ways to assist your young person. Your approach and skills to demonstrate and teach • As mentioned above, work on your own self-care and teach and enable and encourage your young person to work on their own self-care. • Show understanding of the impacts of trauma that can lead to distressing symptoms • Where possible and in a supportive, warm and calm manner, reassure your young person that there are some strategies, therapies and practical things that can really help https://www.blueknot.org.au/Portals/2/Fact%20Sheets%20Info/Fact%20Sheet_Supporters%20Carers.pdf
eheadspace
Moderator
7 Dec. 1:16 pm
eheadspaceMich Skills – some additional skills you can demonstrate, teach and encourage your young person to try: Asking for help Seeking comfort in safe and healthy ways Accepting help or comfort when offered Accepting the answer ‘no’ in a calm way – learning to self-regulate Accepting redirection or feedback – learning to self-regulate Social skills, such as sharing, waiting, communicating Make memory books, time lines, tree of life pictures Practice emotional attunement (this basically means learning to understand your own and others’ emotions and respond appropriately. Feeling understood and that your emotions are able to be expressed can make a big difference to someone who is struggling) Manage meltdowns calmly Help them name feelings, Teach calm breathing, Teach thinking and feeling connection and Teach brain function, Notice triggers Teach high and low alert language
Anonymous 9587
Participant
7 Dec. 1:17 pm
Comment From Kimberley (hYNRG) Hi Hannah, I just wanted to say it sounds like you are doing a brilliant job. There is no perfect solution in these situations, and it sounds like you are taking all the right steps. The only thing I can suggest is to make sure you are fitting in time for yourself and to encourage your family members to do the same.
Anonymous 9587
Participant
7 Dec. 1:17 pm
Comment From Kylie-sky How should you approach a 16 year old girl who claims to have an extremely traumatic background but is naturally depressed and anxious and says she wants to go on medication because she has seen 2 counsellors, a doctor and a psychologist?
eheadspace
Moderator
7 Dec. 1:17 pm
eheadspaceMich Hi Kylie-sky Without knowing too much information, it would be really beneficial to start where your young person is at, and listen to her narrative of the trauma she has experienced. Showing that you are being supportive throughout the healing process by acknowledging her emotions, listening to her concerns and supporting her with the services she is accessing. If she is linked in with all of these services, that is fantastic, and their service team would be making the assessment around whether they believe she should be on medication. As there are many different types of medications, each with different effects the young person might need support in figuring out the best form of treatment to help her cope with her trauma. Educating her via her GP and counsellors on how medication works, and that it itself will not solve the issue, but will be complimented with the work she is doing with her counsellor. Educating the young person on trauma, anxiety and depression may give her the strength to take control of the difficulties and claim some power back onto herself and her current situation. There are resources available, such as those on the headspace website, reach out and apps such as ‘smiling mind’ which can all be used to support your young person in claiming their power back.
Anonymous 9587
Participant
7 Dec. 1:17 pm
Comment From Indy I’m currently at Uni studying social work, and my question is as a social worker or a worker in general in that environment; what tips would you give to help a young person immediately after they have been though a trauma - regardless of what type of trauma
eheadspace
Moderator
7 Dec. 1:17 pm
Di eheadspace Hi Indy, the most important thing to do would be to let them know that you are there for them, that they can come and chat with you whenever they need. You might find that a person does not always want to talk about what happened to them straight away, they might need to process and sometimes go into survival mode, which means they may block the whole trauma out. But it is also helpful to check in with them the next day and again in a few days and in a weeks time.It gives the young person the reassurance that someone is there if they need to seek help. When help is forced upon a young person it can very difficult and can make the situation more traumatic for them.
eheadspace
Moderator
7 Dec. 1:17 pm
eheadspaceMich Explaining trauma to children If your child has been through a traumatic event, it’s important to discuss it with them in a way they can understand. The following tips may be helpful: • Let them know that trauma is common and that it’s OK to be upset • Let them know that the event was not their fault • Provide reassurance and let them know they can come to you for support • Encourage them to talk openly about how they have been feeling, and try to get an idea about any worries they may have or difficulties they are experiencing
eheadspace
Moderator
7 Dec. 1:18 pm
eheadspaceMich Just mentioning again our survey https://www.surveymonkey.com/r/657G5WQ. This survey stays open after the session ends. It would be great to have your feedback! It helps us plan our next sessions so they can be most useful for you
Anonymous 9587
Participant
7 Dec. 1:18 pm
Comment From Kylie-sky eheadspaceMich, is it possible for a young person with dissociation to do things but not realize they are doing them and not remember is after the event?
eheadspace
Moderator
7 Dec. 1:18 pm
eheadspaceAlana Kylie-sky, in regards to your question about dissociation, yes, it is possible to be unaware of one's behaviour whilst dissociating, and to not remember what one did, afterwards. Dissociation is a mental process where a person disconnects from their thoughts, feelings, memories or sense of identity. Dissocation occurs on a spectrum, and in fact we all dissociate when we daydream! But the dissociation you are describing in your young person sounds like it is fairly severe and possibly even dangerous for her. This type of dissociation requires professional treatment. For more info on dissociation, see http://www.isst-d.org/default.asp?contentID=100
Anonymous 9587
Participant
7 Dec. 1:19 pm
Comment From AnnFAF Hi Ricacardo, it is such a sad and hard time when a suicide is involved, perhaps utilising the school services offered at this time would be beneficial. Asking him to talk about how he knew the student, if they had classes together etc just to start the conversation to develop and find out how he is coping
eheadspace
Moderator
7 Dec. 1:19 pm
eheadspaceMich PTSD A diagnosis of PTSD requires a number of criteria to be met: • Presence of one or more intrusive symptoms – intrusive memories of the event; recurrent distressing dreams related to the event; flashbacks; psychological distress or physiological reactions to reminders of the event. • Persistent avoidance of either internal (memories, thoughts, or feelings) or external (people, places, conversations, activities) reminders of the event. • Presence of two or more symptoms of negative changes in mood and thinking – inability to remember an important part of the event; negative beliefs about oneself, others, or the world; distorted beliefs about the cause or consequences of the event; persistent negative emotional state; diminished interest in activities; feelings of detachment from others; inability to experience positive emotions. • Presence of two or more arousal symptoms – irritable, angry, or aggressive behaviour; reckless or self-destructive behaviour; hypervigilance; exaggerated startle response; concentration problems; sleep disturbance. These symptoms must be present for at least one month following trauma exposure for PTSD to be diagnosed. And we will be posting lots of links and resources later in the session....
eheadspace
Moderator
7 Dec. 1:19 pm
eheadspaceMich If you or someone you’re supporting, needs professional help: What can I ask a counsellor? • Is trauma-focussed therapy the best treatment for me? • Why/Why not? • Can you tell me how this type of treatment works? • Does this treatment have any negative effects? • Can you tell me what training and experience you have in this type of treatment? • How long will treatment last? • What can I expect to happen during treatment? • Can you tell me what I will need to do during treatment or in my day-to-day life to help me get better? • What kind of improvements can I expect? • What support will I need while I am having treatment?
eheadspace
Moderator
7 Dec. 1:20 pm
eheadspaceMich What can I ask my doctor about medication? • How does this medication work? • What can I expect to feel like if it works? • Does it have any side effects and how long will they last for? • How long will it take before I start to feel better? • How long will I have to take it? • What do I do if I forget to take my tablets? • When it’s time, how do I go about stopping the medication? • What will happen when I stop taking it?
eheadspace
Moderator
7 Dec. 1:20 pm
eheadspaceMich What if I don’t feel better when I expect to? Some people with PTSD improve quickly, while others take more time to get better. PTSD can also feel more manageable for a while, but worsen at times of stress or when a particularly strong reminder of the trauma triggers a reaction.
eheadspace
Moderator
7 Dec. 1:20 pm
eheadspaceMich Sometimes things that happen during treatment can get in the way of your recovery,eg: • Not receiving enough information about what to expect. • Not feeling comfortable with your GP or counsellor. It takes time to develop trust in someone, but if you continue to feel uncomfortable, discuss it with the person you are seeing or give yourself permission to look for the right person to provide you with help. • Feeling overwhelmed by emotions during treatment sessions. Let the person treating you know how you feel and talk with them about slowing down the process. If you’re not sure treatment is helping you, ask: • My sleep, nightmares, mood, etc aren’t improving. What else can we do? • I had expected to feel better. Can we talk about my progress? • Can we talk about other treatments? What else is available? • Can you give me strategies to help me to better manage my sleep, panic attacks
eheadspace
Moderator
7 Dec. 1:20 pm
eheadspaceMich I like this picture of recovery... Let us know what you think
eheadspace
Moderator
7 Dec. 1:20 pm
eheadspace
Moderator
7 Dec. 1:20 pm
eheadspaceMich And we have a couple of videos you might find helpful
eheadspace
Moderator
7 Dec. 1:21 pm
Babette Rothschild brain response to trauma
eheadspace
Moderator
7 Dec. 1:22 pm
How the brain responds to trauma
Anonymous 9587
Participant
7 Dec. 1:22 pm
Comment From Kimberley (hYNRG) Hi Riccardo, I'm sorry to hear about the loss of your son's friend. I second what the others have said, and if you haven't already, I would also encourage you to ask your son what he needs from you. He may already have an idea what support he would like to recieve.
eheadspace
Moderator
7 Dec. 1:22 pm
eheadspaceMich Sometimes things that happen during treatment can get in the way of your recovery,eg: • Not receiving enough information about what to expect. • Not feeling comfortable with your GP or counsellor. It takes time to develop trust in someone, but if you continue to feel uncomfortable, discuss it with the person you are seeing or give yourself permission to look for the right person to provide you with help. • Feeling overwhelmed by emotions during treatment sessions. Let the person treating you know how you feel and talk with them about slowing down the process. If you’re not sure treatment is helping you, ask: • My sleep, nightmares, mood, etc aren’t improving. What else can we do? • I had expected to feel better. Can we talk about my progress? • Can we talk about other treatments? What else is available? • Can you give me strategies to help me to better manage my sleep, panic attacks
eheadspace
Moderator
7 Dec. 1:22 pm
eheadspaceMich We're still working on your questions everyone!
eheadspace
Moderator
7 Dec. 1:22 pm
eheadspaceMich PTSD treatments Early interventions • In the early aftermath of a traumatic event, routine psychological debriefing is not recommended. The best approach at this time is to offer practical and emotional support and encourage the use of helpful coping strategies and social supports. The goal here is to enhance the person’s natural resilience and coping ability in the face of trauma. • Not everyone who experiences a traumatic event will need professional help. Current thinking is that it is best to monitor people who are more distressed or are struggling and to offer increasingly intensive interventions delivered as needed. Psychological interventions for adults with PTSD: • Adults with PTSD should be offered trauma-focussed psychological interventions (trauma-focussed cognitive behavioural therapy (CBT) or eye movement desensitisation and reprocessing (EMDR)). • Trauma-focussed cognitive behavioural therapy. This is a short-term, structured psychological intervention that aims to address the emotional, cognitive and behavioural impacts of trauma. The two core interventions are: Exposure therapy – which involves confronting the memory of traumatic experiences in a controlled and safe environment (imaginal exposure), as well as confronting trauma-related avoided situations and activities through in vivo exposure Cognitive therapy – which helps the individual to identify, challenge and modify any biased or distorted thoughts and memories of their traumatic experience, as well as any subsequent maladaptive or unhelpful beliefs about themselves and the world that they may have developed
eheadspace
Moderator
7 Dec. 1:23 pm
Cognitive processing therapy CPT is a form of cognitive therapy developed specifically for the treatment of PTSD. It helps the person to identify unhelpful thoughts and beliefs (‘stuck points’), challenge them, and replace them with rational alternatives in an adaptation of standard cognitive therapy approaches. It has a smaller exposure component than traditional exposure therapy (restricted to writing an account of the experience) and is therefore potentially more acceptable to patients or practitioners seeking alternatives to purely exposure-focussed treatments.
eheadspace
Moderator
7 Dec. 1:23 pm
eheadspaceMich Eye movement desensitisation and reprocessing EMDR is based on the assumption that, during a traumatic event, overwhelming emotions or dissociative processes may interfere with usual information processing. This leads to the experience being stored in an ‘unprocessed’ way, disconnected from existing memory networks. In EMDR the person is asked to focus on trauma-related imagery, negative thoughts, emotions, and body sensations while simultaneously moving their eyes back and forth following the movement of the therapist’s fingers across their field of vision for 20–30 seconds or more. (Other similar approaches may use tapping for a similar purpose). This process may be repeated many times. Over time, EMDR has increasingly included more treatment components that are comparable with cognitive behavioural therapy (CBT) using imagination to rehearse coping responses, and exposure therapy.
eheadspace
Moderator
7 Dec. 1:23 pm
eheadspaceMich Complex trauma and treatment Complex trauma is usually interpersonal (occurs between people), and involves ‘being or feeling’ trapped. It is often as a result of planned, extreme, ongoing and/or repeated behaviour. Complex trauma generally leads to more severe, persistent and extreme impacts than single incident trauma. Its impacts tend to be cumulative. They include difficulties with shame, trust, self-esteem, identity, relationships, regulating emotions, and physical and mental health. People affected by complex trauma also often use a range of coping strategies to cope with their trauma and these can include alcohol and drug use, self-harm, over or under-eating When complex trauma occurs as a result of child abuse or other adverse childhood experiences it is particularly damaging. Any form of violence within the community – domestic and family violence, civil unrest, war trauma or genocide, cultural dislocation, sexual exploitation and trafficking and/or re-traumatisation of victims later in life can also cause complex trauma. It’s important to differentiate single incident trauma (PTSD) from complex trauma and deliver services which address the different needs of people affected by complex trauma • The impacts of complex trauma are more extensive and debilitating than the symptoms of PTSD alone. While survivors of complex trauma may experience PTSD symptoms as well and are also at increased risk of PTSD, many experience a greater variety and breadth of adverse impacts. These differences demand differences in treatment (van der Kolk, 2003; Courtois & Ford, 2009). • There is no one perfect trauma therapy’ (Shapiro, 2010:1). All should include core common features which reflect the relevant clinical and neurobiological insights. Trauma therapy needs to involve all dimensions of the person; physiological and somatic as well as affective and cognitive (Ogden, 2006; van der Kolk, 2010; Fosha, 2003). • Specialist treatment guidelines for complex trauma endorse a phased approach to therapy, in which the first stage (safety and stabilisation) is central and foundational prior to processing of trauma (Phase 2) and integration (Phase 3; Courtois and Ford, 2009; Blue Knot Foundation (ASCA), 2012). Trauma is highly dysregulating. It impairs reflective capacity. So a focus on identification and interception of thoughts prior to the ability to self-regulate and manage internal states may itself be re-traumatising. Hence the recommendation that therapy for complex trauma should be phased. • People who experience complex trauma `may react adversely to current, standard PTSD treatments, and that effective treatment needs to focus on self-regulatory deficits rather than `processing the trauma’ (van der Kolk (2003:173).There is a need for more research on effectiveness of treatment for complex trauma • …..treatment does not occur in a vacuum…. A range of things contribute to treatment effectiveness, including the therapeutic alliance and the relational context in which therapy takes place.
eheadspace
Moderator
7 Dec. 1:23 pm
eheadspaceMich Schools: (From the Berry Street site). One of the indicators of poor school engagement is exposure to traumatic stressors including abuse, neglect and violence directed at young people. Unfortunately the frequency of this type abuse is on the rise in Australia. Up to 40% of students have been exposed or witness to traumatic stressors. One in three girls and one in six boys are abused before the age of 18. One of the potential impacts of this abuse is disengagement from school • Trauma affects child development and a child’s ability to successfully navigate and succeed in education. • There are many young people who struggle in their primary years and do not complete their secondary education – a legacy which will last a life-time and have profound social consequences for the community.
eheadspace
Moderator
7 Dec. 1:24 pm
eheadspaceMich Classroom practices for dealing with traumatised children Understand the child Understanding trauma and attachment difficulties brings compassion and empathy; understanding that the child may be developmentally younger than their chronological age will guide teaching practices. Manage your own reactions Working with traumatised children can bring strong emotions; staying calm will help the child to calm themselves. I see you need help with … Help children to comply with requests. Because they don’t necessarily want to please adults, helping them comply will avoid power battles. Structure and Consistency Traumatised children often have little internal structure and need firm boundaries, rules, expectations and consequences— applied with sensitivity and calm. Time in, not time out Traumatised children experience time out as yet more rejection, increasing their feelings of shame and worthlessness; time in keeps them engaged in a relationship. Connect Dissociative children, who are often quiet and compliant, need gentle and consistent attempts to connect with them. Consequences, not punishment Use natural consequences that relate to the problem behaviour and are designed to repair damaged property or damaged relationships. Structure choices to remain in control Offer choices with humour and creativity to avoid power battles; keep the child responding to you rather than allowing them to control the interaction. Acknowledge good decisions and choices Traumatised children often don’t respond well to praise, but still need positive reinforcement for doing something well: comment on the job well done rather than intrinsic characteristics. Support parents and carers Get to know the parents or carers; keep up good communication and don’t communicate through the child. Try to be understanding and compassionate: living with a child who has trauma and attachment difficulties can be very stressful. Maintain your role Don’t be tempted to move too far out of your role. These children need caring and competent teachers.
Anonymous 9587
Participant
7 Dec. 1:25 pm
Comment From Kylie My daughter was raped a few months ago and I’m worried about her. She is refusing to get help and I’m struggling to know how to help her.
eheadspace
Moderator
7 Dec. 1:25 pm
eheadspaceAlana Kylie, we are very sorry to hear what happened to your daughter. It’s distressing to see someone you love affected in that way. We are so glad you’re looking out for her. It is normal for people to vary about when and how they want help. In the case of sexual assault, which by its nature involves a person's control being taken away from them, it's important to give them control over when they get help and who they talk to. But if you really think your daughter is struggling, it might be something you need to explore with her again. See if she will talk about her worries about getting help or the things that might be difficult for her about talking. Sometimes that gives some ideas for how to help overcome these barriers. It may be that your daughter thinks that if she asks for help, she will need to talk about the details of the rape - and she may find this idea quite distressing, having to retell the story. Good trauma therapy does NOT require this, and instead should initially focus on allowing a person to settle down after an assault and begin to feel safe again, without necessarily having to talk about the event,. If she agrees to see a counsellor or therapist, you could talk to them first to ask how they work with trauma. Your daughter may not know that she can do things to help herself as well. Help her try new self-care ideas and put her good self-care habits into practice as much as possible. Many things can be helpful, and of course reinforce healthy rather than unhealthy coping strategies. We ran another group chat session on helping a young person who has experienced sexual assault. It was in partnership with a Centre Against Sexual Assault and you might find it helpful to read it: https://headspace.org.au/eheadspace/group-chat/helping-a-young-person-who-has-experienced-sexual-assault
eheadspace
Moderator
7 Dec. 1:25 pm
eheadspaceMich We're still answering questions but we're going to start posting some links and resources for you to look at too
eheadspace
Moderator
7 Dec. 1:27 pm
eheadspaceMich Books • 8 keys to safe trauma recovery http://www.somatictraumatherapy.com/8-keys-to-safe-trauma-recovery/ • A range of related books http://www.somatictraumatherapy.com/babettes-books/ • The body keeps the score https://www.goodreads.com/book/show/18693771-the-body-keeps-the-score • Getting past your past. The developer of EMDR – written for anyone/not just professionals Getting past your past https://www.booktopia.com.au/getting-past-your-past-francine-shapiro/prod9781609619954.html?source=pla&gclid=EAIaIQobChMI8eeXjvak3QIVjAcqCh2RfwQPEAQYASABEgITa_D_BwE • This is a key text on trauma which looks at historical approach to trauma as well as up to date research. May be more appropriate for professionals but a significant text https://www.booktopia.com.au/trauma-and-recovery-judith-herman/prod9780465061716.html • Trauma and Memory – how the body stores traumatic memories https://www.readings.com.au/products/19756259/trauma-and-memory • Trauma through a child’s eyes https://www.booktopia.com.au/search.ep?keywords=trauma+through+a+child%27s+eyes&productType=917504 • For families and written by families – 2 volumes ‘surviving traumatic grief’ https://catalogue.nla.gov.au/Record/7331874 and volume 1 https://www.kobo.com/us/en/ebook/surviving-traumatic-grief-volume-1-when-loved-ones-die-in-a-disaster after black Saturday bushfires
Anonymous 9587
Participant
7 Dec. 1:27 pm
Comment From Jill I am a foster parent for a young man. Our agency is very helpful and we’re all doing what we can, including giving the school advice. I guess I’m struggling with the impact of this on myself and my family. It’s been a difficult time for everyone and I’m not sure I can keep up the efforts needed.
eheadspace
Moderator
7 Dec. 1:27 pm
eheadspaceAlana Jill, sorry to hear how difficult it is for everyone. It’s natural that others in the family will be feeling some of the effects. Do you get regular breaks as a family? Have you talked to your children about this? You say the agency is helpful, Jill, but I’m wondering if they are aware of how hard you’re finding things at the moment? If they were more aware would they be able to give you and your family some extra breaks perhaps or increase the support for this young man? It might be an idea for you to get some individual support for yourself at the moment too, Jill. It’s so busy as a parent, and you have extra demands on you, so increasing your supports, giving yourself time to really consider your needs and the impact of everything could be a good next step. I hope that the remainder of our session will be helpful for you, though I imagine you’re more aware than many of us of the impacts of trauma and how to support young people.
eheadspace
Moderator
7 Dec. 1:28 pm
Comment From Hannah I can try to have the appointment moved forward - we don't have a lot of services around, so that may not be possible. She has also started to do things that are scaring her peers quite a lot, like writing lists of other students at school she is going to kill and sending it to them (her name is on the list too - thats the only mention of suicide). She is starting to isolate herself from her peers, I think in an attempt to connect with them in a really misguided way, and obviously that sense of isolation is making things even harder for her. When I ask her about these things, she says she is "joking" but doesn't seem to understand that she is scaring her friends. The "kill list" is the third incident in the last two weeks where she has threatened to seriously harm someone or scare people by saying things like "I tried to burn my last house down with everyone inside it." ...I just don't know how to help her. We love her dearly. She has only been with us for around 18 months.
eheadspace
Moderator
7 Dec. 1:28 pm
Di eheadspace Hannah, it sounds like your young person is pushing lots of boundaries as she has no other way of communicating how she is feeling. I am guessing that you are looking after this young person perhaps in a foster care situation, please let me know if this is not the case. Do you have any support from other services. I would suggest contacting the service that you were taking your young person to in October and let them know of some of the things that you are supporting your young person around at the moment and that there is some slight risk in some of the things that they are now talking/writing about. Has the information that your young person has been writing, been something that you have found or that the school has let you know about. The isolating behaviour,that your young person is engaging in with her peers, may be her only way of keeping herself safe. She might be finding it really difficult to try and explain herself or talk about things that require emotions she might not want to be close to anyone. This could be based on past experiences. She may understand that this will push her peers away but not be able to really understand the implications this is going to have on her peers and how they may see her. Her survival mode. Hope this is helpful
eheadspace
Moderator
7 Dec. 1:30 pm
eheadspaceMich Better health channel on trauma – reaction and recovery https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/trauma-reaction-and-recovery Foundation house for survivors of torture, vic. http://www.foundationhouse.org.au/working-with-children-young%20people-and-families/ Post trauma Vic http://www.austin.org.au/mentalhealth/PTRS/PTV/ and consumer and carer consultants at Austin health mental health http://www.austin.org.au/mentalhealth/consumers-carers/ PTSD guidelines http://phoenixaustralia.org/resources/ptsd-guidelines/ At ease – for serving and ex-serving community and their community https://at-ease.dva.gov.au/ Phoenix Australia Centre for Posttraumatic Mental Health. Helping others link. http://phoenixaustralia.org/recovery/helping-others/
Anonymous 9587
Participant
7 Dec. 1:35 pm
SchoolsAnthony Bringing calm to chaos by modelling calm can be very difficult to do when you are facing challenging behaviour. De-escalation is the key here. A heightened young person is incapable of reasoned thought at that time, this can only occur once de-escalation has occurred.
eheadspace
Moderator
7 Dec. 1:35 pm
eheadspaceMich For parents from phoenix Australia (above site) and other resources to download http://phoenixaustralia.org/recovery/fact-sheets-and-booklets/ A guide for parents: http://phoenixaustralia.org/wp-content/uploads/2015/03/Phoenix-Parents-Guide.pdf For young people – understanding trauma, strategies, getting help etc http://phoenixaustralia.org/wp-content/uploads/2015/03/Phoenix-Teenager-Brochure.pdf Recovery http://phoenixaustralia.org/recovery/ Helping children and teens http://phoenixaustralia.org/recovery/helping-children-and-teens/ Bringing up great kids – site for parents http://www.bringingupgreatkids.org/en/ For families – trauma and grief network – supporting families http://tgn.anu.edu.au/ trauma resources http://tgn.anu.edu.au/resource/trauma/
Anonymous 9587
Participant
7 Dec. 1:35 pm
Comment From deanne how can I encourage a teen who suffers social anxiety from childhood trauma?
eheadspace
Moderator
7 Dec. 1:35 pm
eheadspaceAlana Deanne, I'm wondering if your daughter sees a counsellor? If so, it could be good to ask your daughter if it's OK for you to speak to her counsellor, to get some specific ideas that the counsellor might have already worked on with your daughter.
Anonymous 9587
Participant
7 Dec. 1:38 pm
Comment From Michelle So when a group of young men 18 - 19 witness and experience a horrific accident to one of their peers where do these boys go. Individual sessions are old school these boys are banning together and now we create a whole range of social/emotional effects on the community
eheadspace
Moderator
7 Dec. 1:38 pm
SchoolsAnthony Hi Michelle, Each of the young people who witnessed the accident, might be experiencing their own unique responses. Seeking individual support is always a great option, as they may feel uncomfortable to discuss their personal feelings or emotions towards the event in front of their friend. If your group of young people are seeking a place to all chat together, it is possible that they could create their own space with some guidance from a person who is equipped to deliver group therapy supports. It can be difficult to provide a specific service as we are unclear of the exact circumstances your young people are experiencing, but usually these can be provided by schools, universities and some government organisations. Traffic related incidents for example are covered by TAC in Victoria, and similar organisations exist across Australia. There are many culturally specific services within communities that may be able to offer support, and you may be able to find this information through your local council. Your local council may also be able to support your young people, but this would be dependent on where your young people are located.
eheadspace
Moderator
7 Dec. 1:39 pm
eheadspaceMich Services • Phoenix Australia http://phoenixaustralia.org/recovery/find-help/ • Australian childhood foundation https://www.childhood.org.au/ • Blue knot https://www.blueknot.org.au/Survivors/Support Helpline 1300 657 380 • For larger emergencies, see the lists for your state from this page: https://www.australia.gov.au/information-and-services/public-safety-and-law/emergency-services/states-and-territories • Victims of crime services – search in your state. One example: https://victimsofcrimeaustralia.com.au//
Anonymous 9587
Participant
7 Dec. 1:39 pm
Comment From Kimberley (hYNRG) Hi Jill, as someone who works in residental care with young people on care and protection orders, I really want to commend you. I would really encourage you to speak to a support person you trust, and try and identify some strategies you could use to lessen the impact this is having on yourself and your family.
eheadspace
Moderator
7 Dec. 1:39 pm
Di eheadspace Thanks for that very thoughtful comment.
eheadspace
Moderator
7 Dec. 1:41 pm
eheadspaceMich We’re about to finish the session today....in about 2 minutes Thanks everyone for participating and sharing your comments and questions. We really appreciate your contributions. And thanks to our reference group members, Ann and Kimberley.
Anonymous 9587
Participant
7 Dec. 1:41 pm
SchoolsAnthony Good night all and thank you for your participation tonight. I hope it has been of benefit.
eheadspace
Moderator
7 Dec. 1:41 pm
eheadspaceAlana There have been some great questions tonight, on a sensitive topic. Everyone take care of yourself, and if you feel stirred up by any part o this discussion, make sure you talk to a friend or family member you trust, or put in place your self-care strategies.
Anonymous 9587
Participant
7 Dec. 1:41 pm
Comment From Hannah Yes, through foster care. She has been with us for 18 months but I knew her for a few years prior to her living with us full time. I found out about all of the things she has been writing because other kids have shown them to their parents, and they have sent them to me. I've removed her phone for now, in hindsight her emotional maturity isn't high enough for her to have one (and it is only causing more issues with her friends). Her school are wonderful and very supportive, we keep each other in the loop and as it is only a small school they're able to offer her a higher level of support than what some other children may receive. Our agency and her child protection worker are all wonderful too. I'll call the clinic back tomorrow and see if there is anything they can do regarding an earlier appointment - I didn't tell them about the risk when I called to book it in. I just wish that I could do more for her myself. Thank you for your help!
eheadspace
Moderator
7 Dec. 1:41 pm
Di eheadspace Hannah, you are doing some amazing work. Glad to know that you have supports around you to access and how amazing you are with the work you are doing with your young person..
Anonymous 9587
Participant
7 Dec. 1:41 pm
Comment From AnnFAF best of luck to all of you supporting young people. Please be kind to yourselves
eheadspace
Moderator
7 Dec. 1:41 pm
eheadspaceAlana If you need to talk more about anything discussed tonight, you can also contact one of the services we listed earlier.
Anonymous 9587
Participant
7 Dec. 1:41 pm
Comment From Kimberley (hYNRG) Thank you everyone for sharing tonight, take care.
eheadspace
Moderator
7 Dec. 1:41 pm
eheadspaceMich Thanks again everyone : )
eheadspace
Moderator
7 Dec. 1:41 pm
Di eheadspace thanks everyone for all your great questions tonight.
eheadspace
Moderator
7 Dec. 1:41 pm