Centre of Knowledge

Supporting Recovery from Trauma:

Lighthouse Therapeutic Family Model of Care™

Rudy Gonzalez, Executive Director

What Do We Mean by Trauma?

A frightening or distressing event

resulting in a psychological wound or

injury

Resulting InDifficulty coping or functioning

normally following a particular event

or experience

 

Single ComplexOne-off, out of the blue, time-limited Repetitive, prolonged, cumulative, chronic

Impersonal – natural disaster, accident Interpersonal, direct harm, exploitation, maltreatment

Out of context – coming from a stranger In the context of relationships, i.e. primary caregivers, significant others, responsible adult

No relationship to a person’s place in life Often occur at developmentally vulnerable times – early childhood or adolescence

Eg. Road accident, flooding, robbery E.g. Poverty, homelessness, incarceration, exposure to death/ violence

These examples are for illustrative purposes only and are not intended to minimise the effects of any trauma on an individual

Theoretical Underpinnings

• Attachment Theory

• Object Relations Theory

• Psychological Wellness Theory

• Trauma Neurobiology

Object Relations Theory - Winnicott

• Prime motivational drive in humans is to form relationships with others

• Style of relationship that develops in infancy to early childhood becomes part of an internal blueprint or a learned way of relating to others

• Past relationships are replicated when we establish and maintain future relationships, which impact on our sense of identity

• People from traumatic relational environments may have difficulty in forming and maintaining constructive and healthy relationships

Object Seeking Behaviour

“It is as if in early childhood we create a script for a drama and then spent the rest of our lives seeking out others to play the parts. This does not mean the script cannot be changed. However, the more traumatic our early self-object relations, the more rigid and resistant to change we become” (Klee, 2009).

Projective Identification

In projective identification the person who is targeted with the projection begins to

behave, think, and feel in a way that is consistent with what is being projected into him

Projection Projective Identification

Wellness can only be achieved through the combined presence of personal, relational and collective wellbeing

Collective

RelationalPersonal

W

An understanding of how the brain develops has significant implications for us in our work

with traumatised people. It is natural that we first of all relate to a person in a chronological

way. We see a middle aged person and we have normal expectations of a person that age.

However, if a person has been severely traumatised in early childhood their brain may not

have developed at a pace with their chronological age. If a person has been so

traumatised that the limbic and cortex parts of the brain are largely undeveloped, this

person may be functioning in many respects as a child.

Barton, Gonzalez & Tomlinson (2012)

Impact of Trauma on DevelopmentDevelopmental vs. Chronological Age

Trauma Organised System

Activity

Young Person

Worker

Manager

Youn

g Pe

rson

Feel unsafeAngry/aggressiveHelplessHopelessHyperarousedFragmentedOverwhelmedConfusedDepressed

STAF

F Feel unsafeAngry/aggressiveHelplessHopelessHyperarousedFragmentedOverwhelmedConfusedDemoralised

ORG

ANIS

ATIO

N Is unsafePunitiveStuckMissionlessCrisis DrivenFragmentedOverwhelmedValuelessDirectionless

Parallel Process

The Flow of TraumaYP

Worker

Manager

What is Recovery from Complex Trauma?

 

The goal of therapy is to get children back on their developmental pathway

Anna Freud

Recovery is when the child has internalised the therapeutic process

Rudy Gonzalez

Organisational Trauma Informed Practice -Systems Recovery Process

• Therapeutic Relationships

• The Group

• Therapeutic Environment

• The Organisation

• The Community

Therapeutic RelationshipsMichelangelo described his work as a sculptor as a process of

removing the excess marble concealing the beauty of the figure

within. His job, he was reported to have said, was a process of

uncovering rather than creating. Working with people is often like

this. Working effectively with people requires that you create and

shape relationships that are therapeutic….

Fuller (1998)

Therapeutic Group Processes

Recovery from injuries perpetrated in a social context

must occur in a social context. These centers, responsible

for healing, must become therapeutic communities where

recovering is more important than control, and

compassion and empathy drive out fear and coercion.

(Farragher & Yanosy, 2005)

When supervision takes

place in a group setting, a

greater range of feedback,

support, challenges and

viewpoints on clinical

issues can be obtained.

Andersson (2008, p.36 - 38)

When group dynamics are

managed effectively, and the

emotional aspects of the

supervision process are

attended to, the group

supervision setting can provide

invaluable resources that are

not available in the context of

individual supervision.

Andersson (2008, p.36 - 38)

Therapeutic Environment

Traumatised people benefit from caring

environments that are attuned to their

emotional states.

Where workers can adjust the

environment to support emotional

regulation, and can provide predictable

responses and routines that assist in

reducing hyper-arousal.

(Tucci, Mitchell and Goddard, 2010)

Organisations As Therapeutic Settings

Organisation

Internalised by the YP

Operations/ relationships

attuned to the therapeutic

task

Relationships, language,

communication, leadership and

authority = Environment

experienced by child

All staff role model a

healthy sense of

community

Variety of relationships

& circle of care

Provides a therapeutic

milieu

The Organisation as Therapist

The Community

Sense of community:

The feeling that one is part of a readily

available supportive and dependable structure.

Sense of community transcends individualism

in that to maintain such an interdependent

relationship one does for others what one

expects from others.

Sarason (1974)

Overview of the Model

HomePLACE

Playful, Loving, Accepting, Caring, Empathetic

Family Primary Experience

Individualised Care

Individual Development Plan

Professional Development

Plan Staff

Developmentally Focussed

Not Chronologically

Time/Holding Space

Therapeutic/ Recovery Oriented

Sense of Community

TFMC Process of Recovery

Individual Development Plan

LearningPhysical developmentEmotional development

AttachmentIdentitySocial development

Autonomy / life skillsRelational and community ConnectednessFun / play / recreationTransition planning

Psychological Healing Process

Identity confusion Attachment difficulties

Holding spaceTrauma workDealing with loss and rejectionDeveloping insight and awarenessBuilding trust in relationshipsInternal working models

Developing autonomyNew skills consolidationConfidence in relationship building

Lighthouse Process Intake Induction Lighthouse Home Transition After Care

Time-frame Weeks / Months Months / Years Months / Years

www.lighthouseinstitute.org.au