Treating Trauma in a “Zoom” World: Is it even possible?

You might wonder if it is possible to treat post-traumatic stress disorder (PTSD) during a COVID-19 pandemic crisis, but this is the situation that therapists and clients find themselves. Can we find a way to maintain effective treatment through the use of modern technology? Is it possible to treat trauma with this “new world” approach to mental health?

Since the beginning of this year (2020), countries worldwide have worked to protect vulnerable populations from the virus COVID-19. The primary strategies used to prevent the spread of the virus is social distancing and self-imposed quarantine. While this has been effective in reducing the pandemic’s physical effects, it hasn’t protected us from the psychological effects of this unprecedented life-situation. We see an increase in fear, anger, anxiety, panic, helplessness, and burnout in both children and adults. As a therapist working remotely with people dealing with stress and trauma, I have seen several extreme reactions of hallucinations and delusions due to the isolation and continual digestion of negative news media. 

A Healthline.com survey of what COVID-19 is doing to our mental health gives a somber picture: increased worry and insecurity over finances, higher than normal depression and anxiety, prevalent feelings of sadness, and being “on edge,” and an alarming rise in suicides. In America, Federal dollars are being released to increase mental health services nationwide to stem this rising tide of trauma without fully knowing the long-term effects of trauma. 

Therapists, just like the general population, use social distancing and remote work to keep themselves, their families, and their clients safe. Therapists are “front-line responders” and considered “essential workers,” but not all therapists choose to be exposed to 30-40 people a week who might have the COVID virus. Many of them, like myself, have family members who have compromised immune systems and considered to be at-risk. Working from an office and seeing individuals, face-to-face is not an option. Therefore, therapists and clients have to seek alternatives that can be equally beneficial to both. 

The European Journal of Psychotraumatology studied the Telehealth models for post-traumatic stress disorder using cognitive therapy and found that clients rated it as very successful in managing their symptoms. High patient satisfaction ratings were given for both video conferencing and phone call sessions. In the later technology, the only nonverbal communication was the tone of voice, and yet it still benefited clients. 

The journal defines Post-traumatic stress disorder by “a sense of serious current threat, which has two sources: the nature of the trauma memory and excessive negative appraisals.” Traumatized individuals frequently have intrusive, negative thoughts about traumatic experiences and continue to see the world with a negative lens. They have a feeling of hopelessness about their future and easily triggered by daily events. 

Professional organizations are rising to the challenge and providing education and support to remote mental health workers on the unique delivery of mental health through technology. Guidelines have been created by the American Psychological Society, International Society of Traumatic Stress Studies, and the National Institute of Health and Clinical Excellence, specifically targeting PTSD. Governing boards for various mental health professionals are also outlining specific legal and ethical requirements for safe, trustworthy online therapy. 

According to the Psychotraumatology journal article, Telehealth’s use led to “improvements in PTSD symptoms, disability, depression, anxiety, and quality of life, and over 70% of patients recovered from PTSD (meaning they no longer met diagnostic criteria). The Journal of Family Process has reported several articles on the effectiveness of Telehealth with children, adults, couples, and families.

Therapists, offline and online, can provide education and support to (1) reduce negative reactivity in thoughts and emotions, (2) build more effective coping skills, and (3) deepen the quality of life and relationships.

These three areas are healing strategies outlined in my trauma-informed training and therapy. 

The foundation for PTSD work, in face-to-face or video conferencing, is to establish a sense of safety from which to utilize these healing strategies. The client has to trust the therapist, believing he can offer some hope, create an atmosphere of security, and witness the traumatic hurt for PTSD individuals. Empathy isn’t confined to the physical space of the therapist’s office. It can exist in the relational space online as well. Facial expressions on video, tone of voice, empathic responses, and supportive comments assist the connection despite distances.

Finding a private place to have a conversation is one real-world challenge of online work. Privacy can be increased by changing locations (some of my clients go inside cars, relocating to other rooms in the house, or going outside), using headphones, and letting family members know that they can’t be disturbed hour or so. Additionally, therapists can also learn about resources in the client’s living area if referrals are needed. Homework assignments can also be used between sessions and discussed online for adolescents and adults. Parents can participate online with young children, and family members can “zoom” in from different locations at an agreed-upon time. And lastly, follow up with secure emails and text messaging can further increase the outcome of this digital therapeutic medium for PTSD. 

If you are looking for a trauma therapist or someone to help you or a family member with anxiety, contact Ron Huxley today at RonHuxley.com

Be sure to take advantage of our free online resources for families during the COVID-19 Pandemic at FamilyHealer.tv

References: https://www.healthline.com/health-news/what-covid-19-is-doing-to-our-mental-health

https://www.tandfonline.com/doi/full/10.1080/20008198.2020.1785818

https://www.apa.org/practice/guidelines/telepsychology

https://www.ptsd.va.gov/professional/treat/txessentials/telemental_health.asp

Telehealth for Trauma: An effective treatment strategy

According to the National Center for Post-traumatic Stress Disorder, Telehealth or TeleMental Health services are an effective treatment strategy for trauma. Telehealth uses information technology, such as email, phone calls, FaceTime video, and Secure Online Video to conduct therapy services. This technology allows a therapist and a client to engage in real-time two-way interaction. Services that can be provided via Telehealth include assessments, individual and group therapy, psychoeducational interventions, and general therapeutic interactions.

Traditionally, mental health services are engaged in face-to-face, office visits. Just because this is traditional, doesn’t mean that is is more effective. There are times when face-to-face visits are preferred due to lack of adequate technology, challenges with privacy at home, or personal limitations of the client in using technology. In all other situations, TeleHealth is a unique service that provides several benefits, including:

  1. Savings in time and money,
  2. Overcome geographic distance for rural populations,
  3. Increased access to care for individuals with mobility issues (lack of transportation),
  4. Flexibility of appointment times (e.g., out of town for work, babysitting concerns, or other restriction on clients availability like a lunch hour, etc.),
  5. Promotion of physical health by avoiding spreading a contagious illness (COVID-19 or general sickness, like a cold).

Telehealth is not new. It has been used for six decades, in the medical field, and is now being adopted by TeleMental Health as a flexible option for individuals. It is not a “lesser” alternative to mental health care. Outcome research has proven it to be very effective in many areas of mental health issues, like anxiety, depression, and trauma. It also offers convenient support for many general concerns, such as parenting education, life transitions, spiritual direction, and more.

A recent article from the Washington Post points out how global pandemics, like the COVID-19 virus, have shifted the landscape of mental health services through the use of technology allowing more people to attend to their mental health needs. Therapists and individuals may be just blocks away from one another geographically, but medical issues isolate and create an insurmountable “distance” between them. The use of Telehealth or TeleMental Health eliminates geographic and social distance.

The reality is that people around the world are suffering and in need of mental health treatment, education, and support. Children and adults who have experienced trauma cannot wait for medical cures or be punished for lack of mental health access. Telehealth/TeleMental Health is a powerful tool to bring immediate hope and healing.

Learn how to use TeleHealth with Ron Huxley by clicking here!

Read about our security measures and informed consent for Telehealth services here!

SOURCES:

https://www.ptsd.va.gov/professional/treat/txessentials/telemental_health.asp https://www.apa.org/pubs/journals/releases/ser-a0034963.pdf https://www.washingtonpost.com/opinions/2020/03/23/coronavirus-is-mental-health-emergency-too-we-must-remove-barriers-care/?fbclid=IwAR3JK9PIihf_5_nbwbPtgtC1coPpflzmWnAPEDE5FL5kgjsvCnUix_N74aY

Building Family Resiliency (Video)

Parent Connection Coach and Educator Ron Huxley, L.M.F.T., is here to help you and your family build resiliency during these stressful times.
Watch the video and learn how to:
1. Gain new perspectives.
2. Teach your children to be problem solversHelp parents become resiliency coaches and avoid power struggles.
3. Eliminate negative game playing to develop loving and cooperative relationships.

Ron Huxley has over 30 years experience helping families heal and serves as a parent coach and educator with Parent Connection of San Luis Obispo County. In his capacity as a parent coach, Ron specializes in working with families who’ve experienced trauma. He believes in taking a strength-based approach that builds on solutions and he creates strategies that fit each family situation in the shortest time necessary.  


Ron Huxley is a licensed Marriage and Family Therapist providing trauma-informed therapy for individuals and families. Currently practicing on the Central Coast of California, Ron travels internationally educating parents and professionals on trauma-informed care.

Looking for an EMDR therapist?

What is Eye Movement Desensitization and Reprocessing (EMDR)?

Eye Movement Desensitization and Reprocessing (EMDR) is a one-on-one form of psychotherapy that is designed to reduce trauma-related stress, anxiety, and depression symptoms associated with posttraumatic stress disorder (PTSD) and to improve overall mental health functioning.

Treatment is provided by an EMDR therapist, who first reviews the client’s history and assesses the client’s readiness for EMDR. During the preparation phase, the therapist works with the client to identify a positive memory associated with feelings of safety or calm that can be used if psychological distress associated with the traumatic memory is triggered. This is called the “Safe Place” and will be a baseline for the rest of the trauma work. The target traumatic memory for the treatment session is accessed with attention to image, negative belief, and body sensations.

emdrprocess

Repetitive 30-second dual-attention exercises are conducted in which the client attends to a motor task while focusing on the target traumatic memory and then on any related negative thoughts, associations, and body sensations. The most common motor task used in EMDR is side-to-side eye movements that follow the therapist’s finger; however, alternating hand tapping or auditory tones delivered through headphones can be used. The exercises are repeated until the client reports no emotional distress.

The EMDR therapist then asks the client to think of a preferred positive belief regarding the incident and to focus on this positive belief while continuing with the exercises. The exercises end when the client reports with confidence comfortable feelings and a positive sense of self when recalling the target trauma. The therapist and client review the client’s progress and discuss scenarios or contexts that might trigger psychological distress. These triggers and positive images for appropriate future action are also targeted and processed.

In addition, the therapist asks the client to keep a journal, noting any material related to the traumatic memory, and to focus on the previously identified positive safe or calm memory whenever psychological distress associated with the traumatic memory is triggered.

emdrmovements

Ronald Huxley can provide you with EMDR therapy that will decrease anxiety, calm overactive brains/nervous system, resolve past trauma. Contact Ron today by clicking the schedule a session today or call at 805-7090-2023.

Humility Allows Opportunity for Family Healing

Humility is a great opportunity for healing. It creates an ideal mental state that allows you to connect deeply with another human being. When you are in a humble space, I see our relationship as it is, not as I think it is… It restructures the nervous system to “fire and wire” with new neural networks that prepare us for change. This is why pain can bring breakthrough in our life and relationships. It is why loss can develop into growth. It’s not that you want to go through the pain and loss but it can be transformed into some new and precious.

Humility will break-through emotional programs of trauma from the past. In others words, you can get unstuck!

“The reward of humility and the fear of the Lord are riches, honor and life.” Proverbs 22:4

How does trauma impact the family?

A fact sheet from the National Child Traumatic Stress Network.

All families experience trauma differently. Some factors such as the children’s age or the family’s culture or ethnicity may influence how the family copes and recovers. After traumatic experiences, family members often show signs of resilience. For some families, however, the stress and burden cause them to feel alone, overwhelmed, and less able to maintain vital family functions. Research demonstrates that trauma impacts all levels of the family:

■ Families that “come together” after traumatic experiences can strengthen bonds and hasten recovery. Families dealing with high stress, limited resources, and multiple trauma exposures often find their coping resources depleted. Their efforts to plan or problem solve are not effective, resulting in ongoing crises and discord.

■ Children, adolescents, and adult family members can experience mild, moderate, or severe posttraumatic stress symptoms. After traumatic exposure, some people grow stronger and develop a new appreciation for life. Others may struggle with continuing trauma-related problems that disrupt functioning in many areas of their lives.

■ Extended family relationships can offer sustaining resources in the form of family rituals and traditions, emotional support, and care giving. Some families who have had significant trauma across generations may experience current problems in functioning, and they risk transmitting the effects of trauma to the next generation.

■ Parent-child relationships have a central role in parents’ and children’s adjustment after trauma exposure. Protective, nurturing, and effective parental responses are positively associated with reduced symptoms in children. At the same time, parental stress, isolation, and burden can make parents less emotionally available to their children and less able to help them recover from trauma.

■ Adult intimate relationships can be a source of strength in coping with a traumatic experience. However, many intimate partners struggle with communication and have difficulty expressing emotion or maintaining intimacy, which make them less available to each other and increases the risk of separation, conflict, or interpersonal violence.

■ Sibling relationships that are close and supportive can offer a buffer against the negative effect of trauma, but siblings who feel disconnected or unprotected can have high conflict. Siblings not directly exposed to trauma can suffer secondary or vicarious traumatic stress; these symptoms mirror posttraumatic stress and interfere with functioning at home or school.

Download the complete fact sheet at http://TraumaToolbox.com and learn more practical tools on how to have a trauma-informed home. Contact Ron Huxley today to set up a therapy session or organize a seminar for your agency or event at rehuxley@gmail.com / 805-709-2023. You can click on the schedule a session link now on the home page if you live in the San Luis Obispo, Ca. or Santa Barbara, Ca. area.

Are You Mentally Tough?

How quickly can you bounce back from difficult situations? 

Do you feel like you thrive from day to day or is it challenging to just survive each day? 

Resiliency is a popular term in today’s world of positive psychology. The goal is to discover what works and how to use that quality, skill, or mental strategy to feel more effective and capable. 

> Watch Ron Huxley’s video on “The Road to Resilience” here.

Unfortunately, when we experience trauma, we develop protective programs, layered deep in our nervous system, that want to avoid situations that might put us in danger or extreme stress/threat. We want to emphasize that this is a protective program and not a negative one, but that it can continue to play out in our lives and relationships, that is no longer needed in our lives. Being aware we have these program helps us address them which opens a door to learning how to adapt. 

This process of being aware, addressing difficult issues, and learning to adapt is just one way we can increase our mental toughness. 

Mental toughness is about courage, not perfection. 

Facing difficulties, after going through traumatic experiences takes courage. Fighting against our own inner protective programs is hard. Taking risks to trust again is tough. Learning to believe in a hope-filled future seems impossible. This isn’t perfection. It is about the process requiring a change of heart. In faith-based terms, we call this transformation. 

“Do not conform to the pattern of this world, but be transformed by the renewing of your mind. Then you will be able to test and approve what God’s will is—his good, pleasing and perfect will.” Romans 12:2

This verse describes that mental toughness or resilience is an inside job. It doesn’t come from outer performance. It comes from an inner transformation of beliefs about ourselves and the world. It can’t be sustained by an external force. True, lasting toughness comes from a conversation of our will. 

> Watch Ron Huxley’s video on “Faith-Based Trauma Therapy” here.

Kelly McGonical, in her book, The Upside of Stress, doesn’t view stressful events as good or bad. She claims that true resiliency comes from finding the good in the stressful situation and learning new ways to deal with challenges. It isn’t that you have to go through trials in order to learn how to deal with them. We all go through tough times. It is how you react to what you can’t control that helps us be mentally tough. 

Viktor Frankl, Psychiatrist, and Holocaust survivor stated: “Everything can be taken from a man but one thing: the last of his human freedoms – to choose one’s attitude in any given set of circumstances. To choose one’s way (1959).”

Our ability to choose – what we call our will – is the key to bouncing back and moving forward. It is where we find our true freedom. In my own Christian walk, I have found that it is the “truth that sets us free (John 8:32). Trauma not only overwhelms the nervous system, programs protective emotional programs deep within us, it also redefines our identity. 

> Learn more about how trauma affects a child’s brain and development here.

John O’Donohue, contemporary priest, poet, and philosopher, encourages us with the words: “Your identity is not equivalent to your biography. There is a place in you where you have never been wounded, where there’s a seamlessness in you, and where there is a confidence and tranquility. Your life becomes the shape of the days you inhabit.”

Another step to mental toughness is to express daily gratitudes. A lot of scientific studies have been done on gratitude and it has become an foundational tool for shifting our negative attitude in psychology and spirituality. 

> Invite Ron Huxley to speak to your organization or at your next event on Trauma and Trauma-formed Care here.

Try using the Center for Healing Minds exercise called the 5-3-1 Gratitude Practice:

5… Meditate 5 minutes a day focusing on the breath or taking a break from your to-do list to de-stress and calm the mind. You can use various online videos and apps to help with this process. 

3… Write done 3 good things that happened today. Research suggests a positive relationship between gratitude and higher levels of resilience. 

1… Do 1 act of kindness per day. Hold the door open for the person coming into a store behind you, pay someone a compliment, be generous in your tipping.  

Gratitude blesses others and transforms the inner life of the giver. 

Mental toughness is the ability to bounce back, move forward, and shifts negative perspectives. It is how we resist, manage, and overcome difficult moments in our lives. We need it to feel renewed hope following trials and traumas that have impacted our inner self. 

> Take free online courses on Trauma-Informed Care, Parenting, and Anxiety at http://FamilyHealer.tv

The Problem with Labeling Trauma

There is a common problem in social work and mental health today in trying to label people who have experience trauma. The reason for this is that trauma can impact the brain and the body in a way that produces a wide-range of symptoms that can be confusing to understand.

Most professionals are not “trauma-informed” meaning they haven’t received training on how trauma affects every area of human functioning or how to treat the whole person. Trauma, particularly the adverse experiences endured in early childhood, that can result in coping mechanisms that mimic criteria of various clinical diagnoses.

What are some of the labels you have heard placed on traumatized children or adults?

  • Manipulative
  • Oppositional
  • Defiant
  • Hyperactive
  • Temperamental
  • Trouble makers
  • Bipolar
  • Narcissistic
  • Borderline
  • No conscience
  • Destructive
  • Stressed Out
  • and many more…

In addition to a lack of trauma awareness, we are all “meaning-seeking creatures” that want to label everything so that we can feel better about ourselves and our world. Unfortunately, it can do a lot of damage to the people we are labeling. If we label incorrectly, we will treat them incorrectly. This is might also be why so many survivors appear to “sabotage” their success. It isn’t a real desire to ruin their life. They need sensitive professionals and parents who understand how to deal with the root, trauma issues.

Fortunately, there is a national movement to train parents and professionals, who work with traumatized children, to become more “Trauma-Informed.” This movement is reaching out to homes, school, and organizations and explaining “What is trauma?”, “Impact of Trauma on the Brain, Behavior and Health”, “Adverse Childhood Experiences”, “Power of Resilience”, “Regulation Skills”, “Dissociation”, “Mindfulness and Compassion”, “Recognizing Signs and Symptoms of Trauma in Children”, “Attachment Disorders”, “Post-traumatic stress and Post-trauma Growth”, “Trauma in the Community”, “Avoiding Re-traumatization in Survivors”, “Trauma-Sensitive Schools”, “Faith-Based Approaches to Trauma” and more.

The focus of these training efforts is shifting the primary question inherent in treatment plans, screenings, programs and polices from asking “what is wrong with you” to “what has happened to you”. 

This paradigm shift starts the dialogue with survivors, humanizes our practices and helps traumatized children and adults on how to find true healing.

If you would like Ron to train your organization on Trauma-Informed Care, contact him today at 805-709-2023 or email at rehuxley@gmail.com.

The Road to Resilience

June 2019 is PTSD Awareness Month and we are honoring all the victims of war and trauma with one of our TraumaToolbox videos on resilience and the history of PTSD. Get more at http://TraumaToolbox.com

The other side of toxic stress and trauma is resiliency. We can build resiliency skills in our homes, schools, and the community-at-large. Trauma-informed care asks us to make a paradigm shift in our approaches from asking survivors “what’s wrong with you?” to “what happened to you?”. The latter creates safety and respect in our programs and procedures with traumatized children, women, and men.

Learn the six key principles of SAMHSA (Substance Abuse and Mental Health Services Administration): Safety, Trustworthiness, Peer Support, Collaboration, Empowerment, and Cultural Awareness.

Individual strengths of the survivor should be build on, expanded, and celebrated. Together the individual, organization, and community can heal together.

We must move beyond cultural stereotypes and biases and recognize and addresses historical trauma.

These principles lead to the development of the 4 R’s: Realize the impact of trauma, Recognize the signs of trauma, Respond in policies, practices and procedures, and ultimately, to Resist retraumatization.

What does this look like in your organization or business? Get helpful quizzes, handouts, checklists more at TraumaToolbox.com