Healing TR Auma: A Brief Intervention For Women

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H E A L I N G TR AUM A

A Brief Intervention for Women

Stephanie S. Covington, Ph.D.


Eileen M. Russo, M.A.

SCOPE AND SEQUENCE

For more information about this program,


visit hazelden.org/bookstore or call 800-328-9000.
May 2016
HEALING TRAUMA

What is Healing Trauma?


Healing Trauma is a gender-responsive, six-session (90-minute sessions) curriculum for
women, especially designed for settings in which a short-term intervention is needed.
Examples are a community-based program, such as a mental health center; an addiction
treatment program; a private practice setting; a correctional facility (jail or prison); and
an agency addressing domestic violence.
This new edition of Healing Trauma includes
• new and updated foundational information for the facilitator
• new statistics about abuse and other forms of trauma
• new discoveries, publications, and insights in the field; particularly neuroscience
• an additional session, which includes more new lectures and activities for the
participants that reflect current thinking and practice
• a variety of yoga poses, grounding activities, and self-soothing activities
This curriculum promotes a strength-based approach that seeks to empower women
and increase their sense of self. In using this kind of model facilitators will help the
women in the group see the strengths they have and increase the skills they need
for healing. The curriculum also focuses on emotional development. Dealing with the
expression and containment of feelings is a critical part of trauma work. The curriculum
uses psychoeducational and cognitive-behavioral therapy (CBT) techniques, expressive
arts, body-focused exercises, mindfulness, and relational therapy.
This program is designed to help women begin to recover from the effects of
trauma and to help them find ways to grow, flourish, and enjoy healthy relationships
and happier lives. The coping skills that it presents can be useful in dealing with a
variety of traumatic events, although the emphasis is on interpersonal violence.
The women participating in Healing Trauma will go through a process of
understanding what has happened to them and exploring how abuse has affected
them. They will learn more about what abuse is and how widespread it is in women’s
lives. They also will learn coping mechanisms (activities and techniques) to help them
feel grounded and safe.

For more information about this program, visit hazelden.org/bookstore or call 800-328-9000.
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HEALING TRAUMA

What Are the Program Components?


Healing Trauma includes a reproducible facilitator guide and a reproducible participant
workbook (in both English and Spanish) on a CD-ROM or in a digital delivery format.
The facilitator guide contains background information about trauma and session
outlines that are similar to lesson plans. The six sessions in the program are:
• Session 1: Welcome and Introduction to the Subject of Trauma
• Session 2: Power and Abuse
• Session 3: The Process of Trauma and Self-Care
• Session 4: The ACE Questionnaire and Anger
• Session 5: Healthy Relationships
• Session 6: Love, Endings, and Certificates

What Approaches Does Healing Trauma Use?


The Healing Trauma program uses a variety of therapeutic approaches: cognitive-
behavioral therapy, mindfulness, expressive arts, mind-body techniques, and guided
imagery, creating a highly experiential environment. These approaches help the
participants begin to link some of their current difficulties to their trauma histories.
Also, many women do not know about the effects of abuse. A program such as this one
often elicits a response such as, “Oh, someone knows about this? I’ve been hiding this for
years,” or, “I just thought I was crazy.” Many women express relief when they find out
that their thoughts, feelings, and behaviors are normal responses to abnormal events.
The suggested number of participants for a group is between six and ten women.
Ideally, each group would be a “closed group,” meaning the program will be closed
to new members after the first session so the entire group begins and ends together
(although this is not essential). A closed group helps to establish connection among the
group members and reinforces the feelings of safety and group cohesion. The material
in this program builds from session to session, and the first session lays the foundation
for trust among the group members. Once the program is completed, it may be decided
(depending on your setting and if the group members so desire) to let the group continue
as an ongoing support group.
The program can be converted to five sessions by eliminating session 4. This would
make it easier for shorter programs to utilize but would require careful consideration
because important information will be omitted. This is not recommended unless it is
absolutely necessary.

For more information about this program, visit hazelden.org/bookstore or call 800-328-9000.
© Hazelden Betty Ford Foundation. All rights reserved. 3/8
HEALING TRAUMA

Who Are the Authors of Healing Trauma?


Stephanie S. Covington, PhD, LCSW, is an internationally recognized clinician,
organizational consultant, and lecturer. For more than thirty years, her work has
focused on the creation of gender-responsive and trauma-informed services. Her
extensive experience includes designing women’s services at the Betty Ford Center,
developing programs for women in criminal justice settings, and being the featured
therapist on the Oprah Winfrey Network TV show titled Breaking Down the Bars.
She also has served as a consultant to the United Nations Office on Drugs and Crime
(UNODC) in Vienna, and was selected for the federal Advisory Committee for Women’s
Services (ACWS).
Educated at Columbia University and the Union Institute, Dr. Covington has
conducted seminars for behavioral health professionals, community organizations,
criminal justice professionals, and recovery groups in the United States, Canada,
Mexico, Europe, Africa, Iceland, the United Kingdom, and New Zealand. She has served
on the faculties of the University of Southern California, San Diego State University,
and the California School of Professional Psychology. She has published extensively,
including eight gender-responsive, trauma-informed treatment curricula. Dr. Covington
is based in La Jolla, California, where she is co-director of the Institute for Relational
Development and the Center for Gender and Justice.
Eileen M. Russo, MA, is a licensed addiction counselor, a certified clinical
supervisor, and a certified co-occurring disorders professional who has worked in the
addiction and mental health field for the past thirty years. Ms. Russo is an associate
professor for the Drug and Alcohol Recovery Counselor program with Gateway
Community College and, for the past ten years, has served as a trainer-consultant
with the CT Women’s Consortium for the Connecticut Department of Mental Health
and Addiction Services’ Trauma Initiative. In addition to teaching and training, she
specializes in treating co-occurring PTSD in those with mental health and substance
use disorders and assists agencies across Connecticut in developing trauma-informed
mental health/addiction treatment programs for men, women, and children. Ms. Russo
has coauthored articles on the integration of trauma-specific services into addiction
treatment.
She is the principal consultant for the implementation of Healing Trauma in the
York Correctional Institution and for treatment programs in Connecticut. She also is an
adjunct faculty member at the University of Bridgeport.

For more information about this program, visit hazelden.org/bookstore or call 800-328-9000.
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HEALING TRAUMA

What is Trauma?
Trauma is a response to violence or some other overwhelmingly negative experience. It
can happen in many ways: through the oppression of an entire group of people; through
discrimination based on gender, race, poverty, sexual orientation, gender identification,
disability, or age; through the repeated sexual abuse of a child; and so on. It can be
a result of emotional, physical, and/or sexual abuse, as well as assault, war, natural
disasters, and political terrorism.
The Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, defines
trauma as exposure to actual or threatened death, serious injury or sexual violence in
one or more of four ways: (a) directly experiencing the event; (b) witnessing, in person,
the event occurring to others; (c) learning that such an event happened to a close family
member or friend; (d) experiencing repeated or extreme exposure to aversive details
of traumatic events, such as with first responders. In addition, a traumatic event,
regardless of its source, causes significant distress or impairment in the individual’s
social interactions, capacity to work, or other important areas of functioning (American
Psychiatric Association 2013, 271–280).
Trauma occurs when an external threat overwhelms a person’s coping resources.
The type of trauma addressed in Healing Trauma occurs as a result of repeated trauma,
such as active discrimination, sexual abuse, physical battering, and emotional abuse.
Trauma also can result from the threat of abuse and from witnessing violence.
A traumatic event can affect a person in multiple ways. It can affect both the inner
self and the outer self. The inner self includes one’s thoughts, feelings, beliefs, and
values. For example, some women may come to believe that they can’t trust anyone and
that the world is a very unsafe place.
Trauma also can affect the outer self, which consists of one’s relationships and
behavior. Many women who have experienced trauma struggle in their relationships
with family members, friends, and sexual partners. For example, parenting is a
relationship that can become even more complicated by the experience of trauma. Some
women who have experienced abuse in childhood may find that their children remind
them of their previous abuse; consequently, they are flooded with the feelings they
experienced at that time. It is particularly risky when a woman’s child becomes the age
the mother was when her abuse began.
A woman may be triggered in her current life by reminders of a past traumatic
event. There may be nightmares and flashbacks to the earlier experience. This creates
a painful emotional state and affects subsequent behavior. The behaviors we often see

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HEALING TRAUMA

can be placed into four categories: retreat, harmful behavior toward oneself, harmful
behavior toward others, and physical health issues. Women often internalize their
feelings and are more likely to retreat or harm themselves, while men often externalize
their feelings and are more likely to engage in outwardly harmful behaviors. Both men
and women who suffer trauma are at risk for physical health problems.

Disorders Related to Trauma


Health care professionals now recognize that a history of serious traumatic experiences
plays an important, and often unrecognized, role in an individual’s physical and mental
health problems. A number of disorders are related to trauma, including depressive
disorders, anxiety disorders, substance use disorders, and posttraumatic stress disorder
(PTSD).

Trauma and Substance Abuse


A history of abuse drastically increases the likelihood that a woman will acquire a
substance use disorder. Also, a history of family violence may be the most influential
risk factor for abuse of alcohol and other drugs.
Survivors of traumatic experiences may become dependent on alcohol and other
drugs as a way of managing their trauma symptoms and reducing the tension and stress
from living in violent situations. In other words, many addicted women are trauma
survivors who use alcohol or other drugs to medicate the pain of trauma. They are also
more vulnerable to violence because of relationships with others who use substances
and impaired judgment while using alcohol or other drugs, finding themselves in risky
and violence-prone situations. These situations create a cycle of victimization, substance
use, interrupted emotional development, limited coping skills, more substance use, and
increased vulnerability to further victimization.

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HEALING TRAUMA

Scope and Sequence

Session Title Participant Learning Objectives

Session 1: At the end of this session, participants will be able to


Welcome and • describe the purposes of this program.
Introduction to the • define what trauma is.
Subject of Trauma
• explain the purpose of group agreements and what is
included in their group agreement.
• identify personal goals.
• begin to know the group members and facilitator(s).

Session 2: At the end of this session, participants will be able to


Power and Abuse • explain how gender roles and expectations affect
women’s lives.
• describe the connection between power and abuse.
• identify the characteristics of a battering personality.

Session 3: At the end of this session, participants will be able to


The Process of • explain the process of trauma.
Trauma and Self-Care • define what it means to feel grounded.
• describe grounding and self-soothing activities.
• explain the concept of personal boundaries.

Session 4: At the end of this session, participants will be able to


The ACE • explain how the trauma they experienced in the past
Questionnaire affects their present behavior and well-being.
and Anger • describe ways to identify and effectively manage the
feeling of anger.

For more information about this program, visit hazelden.org/bookstore or call 800-328-9000.
© Hazelden Betty Ford Foundation. All rights reserved. 7/8
HEALING TRAUMA

Session 5: At the end of this session, participants will be able to


Healthy Relationships • define what a healthy relationship is.
• explain how respect, mutuality, and compassion are the
basis of a loving relationship.

Session 6: At the end of this session, participants will be able to


Love, Endings, • explain how relationships can be enhanced by
and Certificates understanding oneself.
• describe love in one’s life.
• describe how to end a relationship in a healthy,
respectful way.

For more information about this program, visit hazelden.org/bookstore or call 800-328-9000.
© Hazelden Betty Ford Foundation. All rights reserved. 8/8

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