The Three R's of Trauma Treatment -- Relationship, Responsibility, Resilience -- Core Elements in Treatment
Aug 5, 2012
I recommend people review the excellent video by Mary Jo Barrett -- [LINK] -- Rarely do I come across something that I would unconditionally support to others. This video is one of the rare exceptions.
This is a crucially important topic for survivors of childhood trauma and abuse to understand and I am in the process of addinga page on it to my website -- [LINK] However, the "five essentials" listed by Barrett in her video include:
- a recognition and acceptance, by the therapist and the client that "You have suffered, but things can change for the better"
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Skills building -- such skills might include:
- mindfulness skills -- making room to pause and make choices
- communication skills
- parenting skills
- cognitive behavioural skills
- an acknowledgement that coping required skills (even some "symptoms") which can still be used
- integration skills -- integrating cognitive, spiritual, and bodily (sensorimotor, sensing and soothing type) functions
- a strength orientation -- an understanding of how symptoms have worked in the past as coping skills -- and thus therapy involves a loss, of symptoms, but has benefits as well
- the recognition by the client that during therapy "I felt safe" -- as the therapy was well structured and explained to the client whenever requested by the client, with the therapist regularly checking on the client's understanding and acceptance of therapy processes; and as a result, therapy was predictable, had known boundaries, goals, structure -- this feeling of safety is essential for change to occur, The therapist needs to say "You tell me how to act", and act in a collaborative, elaborative way.
- therapy must involve the creation of "workable realities" -- requiring the therapist to know at all times what they're doing; the client is confident that the therapy is evidence-based; and involves the creation of a workable future, in a concrete, defined way, and not just positive thinking
Barrett quite rightly notes that being able to counsel effectively requires a lot of "energy", the capacity to expend energy yet bounce back to the task when required by the client, thus I view such "energy" as somewhat akin to "resilience" and thus the three R's -- the importance of a safe, collaborative relationship between therapist and client; the therapist being responsible for the qualities of this relationship between established and maintained; and resilience -- absorbing some of the effects of the trauma from the client yet bouncing back with support and guidance when required within the therapeutic relationship.