Inpatient hospitalizations can be difficult for the survivors of sexual and physical abuse unless... more Inpatient hospitalizations can be difficult for the survivors of sexual and physical abuse unless practitioners take care to make the hospital stay trauma informed.
DESCRIPTION This document is a fidelity scale closely tied to the Creating Cultures of Trauma-Inf... more DESCRIPTION This document is a fidelity scale closely tied to the Creating Cultures of Trauma-Informed Care model. It includes ways to gauge an organization's safety, trustworthiness, choice, collaboration, and empowerment for both staff and service recipients. It also addresses domains of formal service policies and procedures, trauma screening and assessment, administrative support for trauma-informed change, trauma education, and human resources practices The document is accompanied by an instructional guide to its use.
ABSTRACT Integrated Trauma Services Teams (ITSTs) provide a model for addressing simultaneously a... more ABSTRACT Integrated Trauma Services Teams (ITSTs) provide a model for addressing simultaneously and in a closely coordinated way the needs of many women survivors for trauma, AOD, and mental health services. Based on the principles of the Trauma Recovery and Empowerment Model (TREM) and centered on the TREM group intervention, these teams offer a trauma-informed context for integrated service delivery and emphasize the development and enhancement of specific trauma recovery skills. Drawing on the importance of gender and culture in understanding and responding to the concerns of women survivors, ITSTs feature individualized recovery plans, a range of trauma-informed group interventions, and peer supports.
Complex relationships among trauma, substance abuse, and mental disorders raise significant quest... more Complex relationships among trauma, substance abuse, and mental disorders raise significant questions for the study of long-term recovery. The purpose of this qualitative study was to examine key themes in sustaining recovery among women with co-occurring disorders who had survived trauma. In semistructured interviews conducted at one of the nine sites of the Women, Co-occurring Disorders, and Violence Study, 27 female trauma survivors described the influences they considered most important in sustaining and hindering their recovery, with an emphasis on recovery from substance abuse. Recurring themes in the interviews were identified. Seven themes emerged from this analysis. Four of these themes supported recovery: connection, self-awareness, a sense of purpose and meaning, and spirituality. Three others served as obstacles to recovery: battles with depression and despair, destructive habits and patterns, and lack of personal control. The women in this study reported that, although ...
This article describes the Trauma Recovery and Empowerment Model (TREM), a manualized group inter... more This article describes the Trauma Recovery and Empowerment Model (TREM), a manualized group intervention designed for women trauma survivors with severe mental disorders, and discusses key issues in its conceptualization and implementation. TREM recognizes the complexity of long-term adaptation to trauma and addresses a range of difficulties common among survivors of sexual and physical abuse. Focusing primarily on the development of specific recovery skills and current functioning, TREM utilizes techniques shown to be effective in trauma recovery services. The group's content and structure are also informed by the role of gender in the ways women experience and cope with trauma.
With the recognition that large numbers of men and women receiving services in the mental health ... more With the recognition that large numbers of men and women receiving services in the mental health and addictions systems are the survivors of sexual and physical abuse, practitioners need to become informed about the dynamics and the aftermath of trauma.
As we try to make sense of our experience, we all rely, to some extent, on stories that organize ... more As we try to make sense of our experience, we all rely, to some extent, on stories that organize and help us process new infor-mation. In some instances, these stories are simply a statement of one's beliefs about one's self; at times they are well articulated personal mythologies. In ...
The authors interviewed 30 patients under age 40 who had been hospitalized repeatedly to determin... more The authors interviewed 30 patients under age 40 who had been hospitalized repeatedly to determine the relationship between social network density, or the extent to which network members know one another, and rehospitalization. They found that moderate levels of network density were associated with fewer days in the hospital. Time spent in the hospital was not related to network size, and patient diagnosis was not a good predictor of hospitalization. The authors hypothesize that a moderately dense network is optimal for psychologically vulnerable individuals because it can be maintained under stress.
Records of service contacts made over a six-month period by 44 chronic mentally ill patients serv... more Records of service contacts made over a six-month period by 44 chronic mentally ill patients served by a private case management agency in Washington, D.C., were analyzed to assess the accuracy of common assumptions held by mental health professionals about appropriate staff-to-patient ratios, the relationship between age and chronicity and use of services, the intensity of service use over time, and similar beliefs. The results suggest that the optimum staff-to-patient ratio is about 1 to 15, that older patients require fewer service contacts than younger patients, that patients' chronicity is not related to their extent of service use, and that patients' frequency of service use does not change over time. Patients who received services at the agency and patients who were seen alone required more service contacts than patients who were seen in the community and patients who were accompanied at their service contacts by members of their support network.
Inpatient hospitalizations can be difficult for the survivors of sexual and physical abuse unless... more Inpatient hospitalizations can be difficult for the survivors of sexual and physical abuse unless practitioners take care to make the hospital stay trauma informed.
Because addictive disorders are so common among women who have experienced prolonged sexual and p... more Because addictive disorders are so common among women who have experienced prolonged sexual and physical abuse, it is especially important to design addictions services that meet the needs of the trauma survivor.
Little is known about the relationship between violence and symptomatology in the lives of homele... more Little is known about the relationship between violence and symptomatology in the lives of homeless, mentally ill women. This study investigates the possibility that specific dimensions of violence-frequency, recentness and type-may be associated with severity of psychiatric symptomatology in this population. Results indicate that each of the abuse dimensions is associated with a broad range of psychiatric symptoms and, in combination with substance abuse, account for almost one third of the variance in overall distress. These findings suggest the possibility that intensity of exposure to violence contributes to the severity of psychiatric symptoms even in women who already suffer an overwhelming number of intrapsychic and social difficulties; and that multiply traumatized women do not become desensitized to the impact of new violence. This article discusses the clinical and policy implications of these conclusions.
... Schizophrenia Bulletin , 16(1): 5767. [PubMed], [Web of Science ®] View all references). TRE... more ... Schizophrenia Bulletin , 16(1): 5767. [PubMed], [Web of Science ®] View all references). TREM-condition clinicians rated the status of the alcohol/drug use disorder during the past 6 months at baseline and 12 months. The TREP (Harris & Fallot, 200114. ...
Inpatient hospitalizations can be difficult for the survivors of sexual and physical abuse unless... more Inpatient hospitalizations can be difficult for the survivors of sexual and physical abuse unless practitioners take care to make the hospital stay trauma informed.
DESCRIPTION This document is a fidelity scale closely tied to the Creating Cultures of Trauma-Inf... more DESCRIPTION This document is a fidelity scale closely tied to the Creating Cultures of Trauma-Informed Care model. It includes ways to gauge an organization's safety, trustworthiness, choice, collaboration, and empowerment for both staff and service recipients. It also addresses domains of formal service policies and procedures, trauma screening and assessment, administrative support for trauma-informed change, trauma education, and human resources practices The document is accompanied by an instructional guide to its use.
ABSTRACT Integrated Trauma Services Teams (ITSTs) provide a model for addressing simultaneously a... more ABSTRACT Integrated Trauma Services Teams (ITSTs) provide a model for addressing simultaneously and in a closely coordinated way the needs of many women survivors for trauma, AOD, and mental health services. Based on the principles of the Trauma Recovery and Empowerment Model (TREM) and centered on the TREM group intervention, these teams offer a trauma-informed context for integrated service delivery and emphasize the development and enhancement of specific trauma recovery skills. Drawing on the importance of gender and culture in understanding and responding to the concerns of women survivors, ITSTs feature individualized recovery plans, a range of trauma-informed group interventions, and peer supports.
Complex relationships among trauma, substance abuse, and mental disorders raise significant quest... more Complex relationships among trauma, substance abuse, and mental disorders raise significant questions for the study of long-term recovery. The purpose of this qualitative study was to examine key themes in sustaining recovery among women with co-occurring disorders who had survived trauma. In semistructured interviews conducted at one of the nine sites of the Women, Co-occurring Disorders, and Violence Study, 27 female trauma survivors described the influences they considered most important in sustaining and hindering their recovery, with an emphasis on recovery from substance abuse. Recurring themes in the interviews were identified. Seven themes emerged from this analysis. Four of these themes supported recovery: connection, self-awareness, a sense of purpose and meaning, and spirituality. Three others served as obstacles to recovery: battles with depression and despair, destructive habits and patterns, and lack of personal control. The women in this study reported that, although ...
This article describes the Trauma Recovery and Empowerment Model (TREM), a manualized group inter... more This article describes the Trauma Recovery and Empowerment Model (TREM), a manualized group intervention designed for women trauma survivors with severe mental disorders, and discusses key issues in its conceptualization and implementation. TREM recognizes the complexity of long-term adaptation to trauma and addresses a range of difficulties common among survivors of sexual and physical abuse. Focusing primarily on the development of specific recovery skills and current functioning, TREM utilizes techniques shown to be effective in trauma recovery services. The group's content and structure are also informed by the role of gender in the ways women experience and cope with trauma.
With the recognition that large numbers of men and women receiving services in the mental health ... more With the recognition that large numbers of men and women receiving services in the mental health and addictions systems are the survivors of sexual and physical abuse, practitioners need to become informed about the dynamics and the aftermath of trauma.
As we try to make sense of our experience, we all rely, to some extent, on stories that organize ... more As we try to make sense of our experience, we all rely, to some extent, on stories that organize and help us process new infor-mation. In some instances, these stories are simply a statement of one's beliefs about one's self; at times they are well articulated personal mythologies. In ...
The authors interviewed 30 patients under age 40 who had been hospitalized repeatedly to determin... more The authors interviewed 30 patients under age 40 who had been hospitalized repeatedly to determine the relationship between social network density, or the extent to which network members know one another, and rehospitalization. They found that moderate levels of network density were associated with fewer days in the hospital. Time spent in the hospital was not related to network size, and patient diagnosis was not a good predictor of hospitalization. The authors hypothesize that a moderately dense network is optimal for psychologically vulnerable individuals because it can be maintained under stress.
Records of service contacts made over a six-month period by 44 chronic mentally ill patients serv... more Records of service contacts made over a six-month period by 44 chronic mentally ill patients served by a private case management agency in Washington, D.C., were analyzed to assess the accuracy of common assumptions held by mental health professionals about appropriate staff-to-patient ratios, the relationship between age and chronicity and use of services, the intensity of service use over time, and similar beliefs. The results suggest that the optimum staff-to-patient ratio is about 1 to 15, that older patients require fewer service contacts than younger patients, that patients' chronicity is not related to their extent of service use, and that patients' frequency of service use does not change over time. Patients who received services at the agency and patients who were seen alone required more service contacts than patients who were seen in the community and patients who were accompanied at their service contacts by members of their support network.
Inpatient hospitalizations can be difficult for the survivors of sexual and physical abuse unless... more Inpatient hospitalizations can be difficult for the survivors of sexual and physical abuse unless practitioners take care to make the hospital stay trauma informed.
Because addictive disorders are so common among women who have experienced prolonged sexual and p... more Because addictive disorders are so common among women who have experienced prolonged sexual and physical abuse, it is especially important to design addictions services that meet the needs of the trauma survivor.
Little is known about the relationship between violence and symptomatology in the lives of homele... more Little is known about the relationship between violence and symptomatology in the lives of homeless, mentally ill women. This study investigates the possibility that specific dimensions of violence-frequency, recentness and type-may be associated with severity of psychiatric symptomatology in this population. Results indicate that each of the abuse dimensions is associated with a broad range of psychiatric symptoms and, in combination with substance abuse, account for almost one third of the variance in overall distress. These findings suggest the possibility that intensity of exposure to violence contributes to the severity of psychiatric symptoms even in women who already suffer an overwhelming number of intrapsychic and social difficulties; and that multiply traumatized women do not become desensitized to the impact of new violence. This article discusses the clinical and policy implications of these conclusions.
... Schizophrenia Bulletin , 16(1): 5767. [PubMed], [Web of Science ®] View all references). TRE... more ... Schizophrenia Bulletin , 16(1): 5767. [PubMed], [Web of Science ®] View all references). TREM-condition clinicians rated the status of the alcohol/drug use disorder during the past 6 months at baseline and 12 months. The TREP (Harris & Fallot, 200114. ...
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