Three New Courses!

TraumaOnline

The newsletter of the

International Trauma Training Institute (ITTI)

www.traumaonline.net

Mike Dubi, Ed.D., LMHC, Editor

Jeanne Thomas, MBA, Associate Editor

Summer 2023, Vol. 6, No. 1

ITTI is a leader in continuing education for mental health professionals. See our full list of courses below.

Hello to Everyone:

ITTI is now in its 14th year and wow, time really does fly. And over that time we have provided continuing education to over 35,000 mental health professionals, and still counting. This summer/fall, we have launched three new courses: our newly-created Counseling Aging Seniors (CAS); a critically-needed Crime Victims: An Integrated Approach (WCV); and an updated version of our most popular course, Clinical Trauma Professional (CTP). You can read more about these courses below.

If you have taken an ITTI course already, we thank you and hope to see you again in some of our new courses. If you are new to ITTI, welcome aboard and we look forward to a long relationship with you.

Your continuing support is greatly appreciated.

Mike Dubi

President, ITTI

THREE NEW COURSES!

Counseling Aging Seniors (CAS), 18 CE Hours

James J Messina, Ph.D., NCC, CCMHC, DMHS-T

The Good News is that on December 23, 2022, Congress passed the Mental Health Access Improvement Act (S.828/H.R.432), a bill which expanded Medicare coverage to include two new groups of mental health providers: Licensed Mental Health/Professional Counselors and Licensed Marriage and Family Therapists. This legislation signed by President Biden goes into effect January 2024 and adds marriage and family therapists and mental health counselors to the list of health care practitioners who can accept payment from Medicare Part B health insurance. Part B is the component of Medicare that covers outpatient services, such as doctor visits.

The Bad News is that most of these therapists and counselors have had no formal training in serving clients who are 65 years or older.

But the Good News is that ITTI is now offering training for therapists and counselors in the field of gerontology to catch them up to speed on the needs of this senior population and the evidenced based treatment approaches which assist them in dealing with their mental health concerns.

ITTI’s program is entitled: Counseling Aging Seniors. It has 18 modules which you can take online at your own speed. There are post tests for each module to help you retain the information being provided. The material is divided into two major focus areas: 1) the clinical needs and evidence-based approaches to meet these needs of Seniors; and 2) on the logistics of Medicare clinical requirements and the need for Counselors and Therapists to be committed to becoming advocates for Aging Seniors.

You will then be able to begin to use the narrated modules as soon as you are registered. All trainees who complete the 18-module program will then be able to join the author of this training program, Jim Messina, in a free one-hour live webinar (date to be determined) to discuss issues covered in the program and to problem solve issues with your aging senior clients.

The goal is to help counselors and therapists to be as prepared as possible when the Medicare Reimbursement program comes into reality in January 2024.

Crime Victims: An Integrated Approach (WCV), 13 CE Hours

Cheryl Paulhus, Ed.D., LPC-S, CCTP, RVT

In America, millions of violent crimes happen each year. In ITTI’s new course, Crime Victims: An Integrated Approach, we will explore violence in society, review interpersonal violent crimes and its relationship to psychological trauma, and discover the societal and personal factors that contribute to or help prevent violence.

This course will introduce mental health professionals, educators, and those interested in the criminal & social justice field to the scientific study of victimology. This course will focus on criminal victimization, including its scope and development, historical and political movements impacting victims, and a myriad of behavioral health issues from which they suffer.

Participants will explore pertinent assessment factors and the latest treatment modalities through a holistic and integrated approach which speaks to the whole person and the context in which they live. We will discuss various practical and clinical applications and initiatives that have resulted from society’s increasing concern about the enormous impact of victimization on our culture, communities, nation, economy, and the world.

Clinical Trauma Professional (CTP), 13 CE Hours

Mike Dubi, Ed.D., LMHC

This updated and expanded version of our most popular course contains new and current material, including the Polyvagal Theory, medications and medical interventions, and extensive new information on treatment interventions, such as EMDR, Bilateral Stimulation and Brainspotting as effective treatments of traumatic stress. Also included: relaxation techniques, self-regulation, exposure, somatic therapy and narrative therapy in trauma treatment.

Mike Dubi is the founder and president of ITTI.

OPEN ENROLMENT

To see all course descriptions and to register, click this link:

http://traumaonline.net/online-training/

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A CLOSER LOOK AT THE IMPACT OF POSITIVE PARENTING WITH CHILDREN WHO

EXPERIENCE INTERGENERATIONAL TRAUMA

Brittany McBryde Williams, MA, LMHC & Andy R. Brown, Ed.D., LCMHC

Trauma and efficiency are not two words trauma providers typically associate together. The therapeutic process can feel cyclical when the expectation is a linear trajectory. The dissonance in this expectation versus reality inevitably leads to an exhausted therapist and a frustrated client. Trauma practitioners eventually begin to step back to reflect on program efficacy and treatment outcomes, resulting in recognition of intergenerational trauma. Consider for a moment the amount of time and energy that goes into restoring an original 1969 Chevy Camaro SS. There is a methodical checklist for restoring an old car. When the job is complete, the feeling of accomplishment and satisfaction is relative to the effort put into the project. From the intricate bodywork, the interior repair, to the painstaking replacements of the engine, transmission, AC, and electrical systems, all the way to the new paint job results in the pure splendor of the complete restoration. The intense satisfaction of that first joy ride has minimal comparison until a giant scratch on the passenger fender appears. The scratch’s origin is unknown; a stranger at the grocery store may have put it there. At this moment, the car owner may have an equally disturbing if not greater intensity of distress and devastation to see such an offense mar the restoration work.

The owner of the scratched, restored Camaro may experience the same deflated feeling that a trauma care provider experiences when he or she treats children. Similar to overlooking parental mental health needs, which can inevitably diminish emotional healing, not paying attention to details during an automotive restoration project can result in many issues unknown to the owner. In this scenario, the child is to the Camaro as the trauma work is to the restoration job, and it is the provider’s job to address the repairs and offer restorative healing and care. Imagine the scratch as the parent with personal trauma responses ingrained into their parenting strategies. The parent’s responses inadvertently sabotage progress for the child. As frustrating as the metaphor of a scratched-up restored ’69 Camaro feels, the frustrations amplify when a trauma provider makes headway with a child in therapy and sends the child home to the same environment only to have all the progress unraveled by a parent triggered by trauma.

Often, a triggered parent is an unsafe and dysregulated inner child who exerts power to gain control. Similarly, the Authoritarian parenting approach is rooted throughout history to combat a child’s opposition and achieve control. Often, this happens through the coercive and confrontational assertion of parental power (Baumrind, 2012). Combining such power assertion strategies in the parent-child dynamic coupled with unresolved parental trauma can potentially damage the child’s development and mental health (Baumrind). Additionally, the power struggle destabilizes the parent-child attachment when the parent goes into survival mode once their own trauma is triggered and their amygdala is activated. Transmission of parental trauma to younger generations, whether directly or indirectly, is referred to as intergenerational trauma or IGT (Cramer, 2019). The impact of intergenerational trauma shows much room for the breadth of understanding and implications, as evidenced by the continued cycle of trauma transmission from parent to child.

Treatment outcomes vary for trauma work with children. Intergenerational trauma is one of the factors driving this differentiation. Therapists meet kids where they are, often deeply wounded and unsafe, and then strive to provide unconditional positive regard coupled with intricate tools and intervention. The accepted goal of pediatric trauma care is to delicately disarm the child’s land mines of unresolved issues from trauma, but this falls short when therapists fail to consider their systemic environmental origin when it conflicts with the core ideas of healing. This result is a revolving door in therapy for the child and a heavy train of diagnosis alphabet soup following them into their adult lives.

Assessment is a vital aspect of the treatment process. If this component is faulty, the treatment outcomes are poor, which is evident when someone is diagnosed based on symptom checklists instead of conceptualizing the client from a psychosocial standpoint. For this reason, it is imperative to take a closer look at not just the clients themselves as children but also the other moving parts in their situation (i.e., development, family role, parenting style, and parental trauma). Currently, there is no formal diagnosis in the DSM-V encompassing intergenerational trauma (Lefebre-McGevna, 2006). There is also a lack of appropriate diagnoses for developmental trauma. Developmental trauma is trauma experienced throughout childhood yet does not meet the criteria of other formal trauma disorders. Therapists agree there is a need for a diagnostic distinction to better conceptualize the impact of childhood trauma on a person’s life across the lifespan.

These inefficient moments in treating trauma with children leave clinicians in agreement that there needs to be a shift towards a protocol that can be implemented with trauma-informed care for child therapy. Psychotherapist and pioneer of Individual Psychology, Alfred Adler, posed that a person seeks a sense of belonging and strives for social and interpersonal connectedness (Gfroerer, Nelsen, & Kern, 2013). Terry Kottman graced the field of Child Therapy when she took the Adlerian approach to another level by integrating these principles from Adler’s theory into the world of Play Therapy. As one of the top three most widely used approaches by people who work in play (Kottman, 2020), Adlerian Play Therapy aims to elicit therapeutic change when there is an egalitarian relationship and social collaboration between client and therapist. If this can occur in the Play Therapy room, why not replicate it in the home? Dr. Jane Nelsen has spent a lifetime studying the work of Adler and Rudolf Dreikurs and uses the framework of Adlerian Therapy. Nelsen suggests that, as in the therapeutic space, collaboration and social connectedness must be present between caregiver and child in the home to propel and sustain change. Therefore, she has developed a parenting program with the underpinnings of this theoretical approach called Positive Discipline, which is designed to “teach young people to become responsible, respectful, and resourceful members of their communities” (Nelsen, 2021). She achieves this by offering a parental reframe in which the parent modifies their worldview, how they see their child and their behavior, and how they should respond. Dr. Nelsen writes, “Parenting with Positive Discipline means being kind and firm at the same time, which is effective long-term and helps children feel a connection - a sense of belonging and significance” (Nelsen). In this communication model between parents and children, therapists and parenting facilitators can teach the parent-child team to navigate around intergenerational trauma to promote healing for the parent and show the child how to heal from these deep wounds. Ultimately, the goal is to break the cycle of victimization.

Trauma providers need a new path forward to help parents see how their traumatic pasts impact their parenting in the present. Traumatized parents need to learn that they can help their children progress in trauma care. Adler, Kottman, and Nelsen have laid a foundation of research for providers to explore a new approach to managing the child’s adverse experiences while also helping the parent move toward healing. Ultimately, parents should communicate with their children in a manner that shows the child encouragement and respect.

References

Baumrind, D. (2012). Differentiating between confrontive and coercive kinds of parental power-assertive disciplinary practices. Human Development, 55(2), 35-51. doi:https://doi.org/10.1159/000337962

Cramer, S. (2019). Intergenerational narrative practice in response to intergenerational trauma. The International Journal of Narrative Therapy and Community Work, (1), 1-6. Retrieved from https://www.proquest.com/scholarly-journals/intergenerational-narrative-practice-response/docview/2207814626/se-2?accountid=36783

Gfroerer, K., Nelsen, J., & Kern, R. M. (2013). Positive Discipline: Helping Children Develop Belonging and Coping Resources Using Individual Psychology. The Journal of Individual Psychology, 69(4), 294–304.

Kottman, T. (2020). Adlerian play therapy: A personal and professional journey. The Journal of Individual Psychology, 76(2), 162-175.

Lefebre-McGevna, J. A. (2006). A Developmental Attachment-based Play Therapy (ADAPT™): A new treatment for children diagnosed with reactive attachment and developmental trauma disorders. University of Hartford.

Nelsen, J. (2021, March 14). About positive discipline. Dr. Jane Nelsen. Retrieved June 9, 2022, from https://www.positivediscipline.com/about-positive-discipline

About the Authors

Brittany McBryde Williams is a Licensed Mental Health Counselor in Central Florida working in group private practice serving children, families, and adults. She obtained her Master’s degree from Capella University and is an active member of the Florida Mental Health Counselors Association as well as the Association for Play Therapy. She holds a certificate in play therapy and is an EMDR therapist in training. Brittany is passionate about helping her clients achieve transformative healing through the lens of trauma informed work.

Andy Brown, Ed.D., LCMHC, Master Traumatologist is a Full Professor of Mental Health Counseling at the Chicago School of Professional Psychology and on the ITTI Board of Directors. He has a private practice in North Carolina.

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CAN CEAP AND SAP

HELP YOU GROW YOUR PRIVATE PRACTICE?

Mary Bradshaw, Ed.D., LMHC

What exactly is a CEAP?

The CEAP (Certified Employee Assistance Professional) is a credential enshrined in the international standards for EAP (Employee Assistance Program) excellence since 1987. A CEAP has demonstrated a proficiency in the body of knowledge required for competence in EA practice. It is recognized in all 50 States and internationally by EAPs employers, accrediting agencies, third-party insurers, and clients. The certification is administered by the Employee Assistance Certification Commission (EACC), an independent adjunct of the Employee Assistance Professionals Association (EAPA).

What is an SAP, you may ask?

An SAP represents the primary decision point (and in some cases, the only decision point) an employer may have to choose whether to return an employee to their job. Examples of the type of jobs are behind the steering wheel of a school bus, in the cockpit of a plane, at the helm of an oil tanker, at the throttle of a train, in the engineer's compartment of a subway car, or the emergency control valves of a natural gas pipeline.

Your responsibility to the public is enormous! As an SAP, you are not an advocate for either the employer or the employee. The function of an SAP is to protect the public interest in safety by professionally evaluating the employee and recommending appropriate education and treatment, follow-up tests, and aftercare.

Mary Bradshaw, Ed.D., LMHC, CEAP, SAP. Mary works extensively in disaster areas for FEMA throughout the U.S. and its overseas territories.

TRAININGS