Beyond Trauma 101: A Phase Model for Comprehensive Treatment of Trauma and Strategies for Treating Attachment Disorders
COURSE DATE
22 & 23 Feb 2023 (8.30 am to 11 am) & 1 Mar 2023 (8.30 am to 11.30 am)
Course Fee
Normal Fees: S$580
SkillsFuture Credit: Can use fully or partially
NTUC UTAP: Reimbursement of 50% of course fees (up to $250/year)
NCSS VCF Pre- Approval Funding: S$174
Schools & Ministries: e-invoicing via vendor.gov
Delivery Mode
Zoom
about the trainer
Ms Annie Monaco (LCSW-R, RPT) is a New York State Licensed Clinical Social Worker, Registered Play Therapist and a faculty member of the Child Trauma Institute & Trauma Institute and of University at Buffalo School of Social Work. Annie travels throughout the US and internationally providing a multitude of trauma-informed trainings and agency and therapist consultation. Annie is an EMDRIA approved trainer of EMDR, Progressive Counting and STAR (Strategies for Trauma Awareness and Resiliency). Annie also provides specialty trainings on attachment, dissociation, and EMDR with Teenagers and with younger children. Annie was a Director of Restorative Justice programs at a non- profit agency where she oversaw juvenile and adult offender programs for over 10 years. Ms. Monaco has extensive experience and training in teens, family therapy and working with the juvenile justice population. Presently her private practice includes a multitude of behaviours and issues including foster care, out of country adoptions, juvenile justice and dissociation. Annie is the co-editor and contributor of chapters for EMDR with Children in the Play Therapy Room, an integrated approach (2020)
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What Participants Say
Excellent course. It is very useful and the sharing by the trainers were very insightful - Senior Counsellor in a government ministry
Through this course, I have learned attachment assessment and intervention skills like Future Self and Community of Care - Counselling Director in a private clinic
Besides direct application (of techniques learnt) on clients with trauma history, I hope to share tools with co-workers who are also directly interfacing with clients with trauma - Director in a social service agency
I can't wait to use the case consultation constructs, the wonderful scripts and extensive Attachment and Trauma History questions in therapy with my clients! - Assistant Manager in a social service agency
Through this course, I have learned attachment assessment and intervention skills like Future Self and Community of Care - Counselling Director in a private clinic
Besides direct application (of techniques learnt) on clients with trauma history, I hope to share tools with co-workers who are also directly interfacing with clients with trauma - Director in a social service agency
I can't wait to use the case consultation constructs, the wonderful scripts and extensive Attachment and Trauma History questions in therapy with my clients! - Assistant Manager in a social service agency
Course Overview
The brain and the body’s response to traumatic experience are now understood to be a factor in the emotional and mental health problems of our clients. This eight-hour workshop will help counsellors understand what constitutes trauma and learn what behavioural symptoms are an outcome of traumatic events as well as apply in-depth information about disrupted attachment and how clients have dissociated reactions due to the impact of early childhood trauma. Being familiar with trauma symptoms, attachment wounds, and dissociative reactions will help the professional shift their thinking and take a different approach to providing treatment to their clients.
Attachment disordered clients are a specialised population that unfortunately have become more the norm with therapists than the exception. These are our most challenging clients and special interventions need to be provided to assist these clients to improve their functioning at home, school, work and community.
In this first part of the 'Beyond Trauma 101' series, participants will learn an overarching Phase Model to guide interventions during treatment of a client. The phase model consists of crucial case management activities, re-setting of nervous system activities (building up internal resources) and learning about evidence-based trauma treatment options. We will explore the phase model and practice different aspects and examples of each phase. Participants will also view their challenging cases through a trauma lens and utilise a case consultation format throughout the two days and come up with interventions that are appropriate to their case.
This workshop will also help participants to develop clearer case conceptualisation for our most difficult clients. It will be especially helpful to understand how wounded attachments have lifelong implications on the ability to form and sustain relationships, including in therapy. We will explore the latest developments in attachment theory, including the impact on window of tolerance for affect, and polyvagal theory (Porges), and how to apply this understanding to clinical work. We will teach attachment repair interventions for both children, their parents as well as our adult clients which can provide corrective experiences and lay out the path to healing.
This is a hands-on, clinical skills-based workshop that uses lecture, experiential exercises and scripted interventions that will be practiced in the workshop.
Workshop Objectives
Target Audience
This workshop is designed for any mental health professionals (or graduate level students) working with children, adolescents and adults in a therapy session. This can include social workers, psychologists, counsellors, school counsellors and any other counselling disciplines. This is a hands-on clinical skills training for working with clients who have been exposed to significant trauma or loss.
Important Note:
Duration
8 hours via Zoom. Due to time difference between USA and Singapore, this workshop will be conducted in the mornings (Singapore Time)
Workshop Topics:
Part 1
Part 2
Research Support
The evidence in support of the lifelong impact of trauma has been well established by the ACE study and the research which has followed it (Felitti, et al, 1998). The comprehensive phase model of trauma-informed treatment was developed based on years of research support from Pierre Janet, Judith Herman and more recent work by Cloitre (2021), van der Hart (2005) and EMDR researchers with children including Greenwald. (Greenwald, 2002, 2009, 2013). A phase model with 1) robust case conceptualization and psychoeducation for the client, 2) somatic and mindfulness-based strategies for regulation and 3) when ready, trauma exposure work to reprocess the trauma, are the foundation of all the current evidence-based trauma treatments. Our goal is to provide examples of adaptation of proven-effective methods to real-world situations, and providing a systematic guide to every step of treatment for the therapist based in the community.
We have relied on the published work of other experts in the field of trauma and dissociation to develop the sequence of interventions we are teaching. Additional supportive material related to the neurobiology of attachment comes from Laurel Parnell ( 2013), Stephen Porges (2011), Philip Manfield (2010), Joyanna Silberg (2012) and established and innovative approaches to conceptualizing and intervening with dissociation (Van der Hart, et.al, 2005, Waters, F. , 2016).
Bibliography
Badenoch, B. (2008) Being a Brainwise Therapist: A Practical Guide to Interpersonal Neurobiology.New York: Norton.
Cloitre, M. (2021) Complex PTSD: assessment and treatment, European Journal of Psychotraumatology,12:sup1, DOI: 10.1080/20008198.2020.1866423
Felitti, Vincent J; Anda, Robert F; et al. (1998). "Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study". American Journal of Preventive Medicine. 14 (4): 245–258.
Ecker, B., Ticic, R., & Hulley, L. (2012). Unlocking the emotional brain: Eliminating symptoms at their roots using memory reconsolidation. NY: Routledge
Greenwald, R. (2009) Treating Problem Behaviors. New York: Routledge.
Greenwald, R. (2013) Progressive Counting within a phase model of trauma-informed treatment.London: Routledge.
Greenwald, R. (2002b). Motivation-adaptive skills-trauma resolution (MASTR) therapy for adolescents with conduct problems: An open trial. Journal of Aggression, Maltreatment and Trauma, 6. 237-261.
Hughes, D. (1998) Building the Bonds of Attachment: Awakening Love in Deeply Troubled Children. Lanham, Maryland: Jason Aronson Publishing.
Herman, J.L., Harvey, M.R. Adult Memories of Childhood Trauma: A Naturalistic Clinical Study. J Trauma Stress 10, 557–571 (1997). https://doi.org/10.1023/A:1024889601838
Herman, J. L. (2002). Recovery from psychological trauma. Psychiatry and Clinical Neurosciences, 52(S1), S105–S110. https://doi.org/10.1046/j.1440-1819.1998.0520s5s145.x
Knipe, J. (2009). Back of the head scale (BHS). In M. Luber (Ed.), Eye movement desensitization (EMDR) scripted protocols: Special populations(pp. 233-234). New York, NY: Springer.
Mahler, K. (2015) Interoception: The Eighth Sensory System. Kansas: AAPC Publishing.
Manfield, P. (2010) Dyadic Resourcing: Creating a Foundation for Processing Trauma. California: Createspace Independent Publishing.
Ogden, P. & Fisher, J. (2015) Sensorimotor Psychotherapy. New York: Norton.
Parnell, L. (2013) Attachment-focused EMDR: Healing Relational Trauma. New York: Norton.
Porges, S. (2011) The Polyvagal Theory. New York: Routledge.
Silberg, J. (2012) The Child Survivor: Healing Developmental Trauma and Dissociation. New York: Routledge.
van der Hart, O., Brown, P. & van der Kolk, B.A. Pierre Janet's treatment of post-traumatic stress. J Trauma Stress 2, 379–395 (1989). https://doi.org/10.1007/BF00974597
Van der Hart, O. Nijenhuis, E. , & Steele, K. (2005). Dissociation: An Insufficiently Recognized Major Feature of Complex PTSD, Journal of Traumatic Stress, 18 (5).
Waters, F. (2016) Healing the Fractured Child: Diagnosis and Treatment of Youth with Dissociation. New York: Springer.
Online resources:
The brain and the body’s response to traumatic experience are now understood to be a factor in the emotional and mental health problems of our clients. This eight-hour workshop will help counsellors understand what constitutes trauma and learn what behavioural symptoms are an outcome of traumatic events as well as apply in-depth information about disrupted attachment and how clients have dissociated reactions due to the impact of early childhood trauma. Being familiar with trauma symptoms, attachment wounds, and dissociative reactions will help the professional shift their thinking and take a different approach to providing treatment to their clients.
Attachment disordered clients are a specialised population that unfortunately have become more the norm with therapists than the exception. These are our most challenging clients and special interventions need to be provided to assist these clients to improve their functioning at home, school, work and community.
In this first part of the 'Beyond Trauma 101' series, participants will learn an overarching Phase Model to guide interventions during treatment of a client. The phase model consists of crucial case management activities, re-setting of nervous system activities (building up internal resources) and learning about evidence-based trauma treatment options. We will explore the phase model and practice different aspects and examples of each phase. Participants will also view their challenging cases through a trauma lens and utilise a case consultation format throughout the two days and come up with interventions that are appropriate to their case.
This workshop will also help participants to develop clearer case conceptualisation for our most difficult clients. It will be especially helpful to understand how wounded attachments have lifelong implications on the ability to form and sustain relationships, including in therapy. We will explore the latest developments in attachment theory, including the impact on window of tolerance for affect, and polyvagal theory (Porges), and how to apply this understanding to clinical work. We will teach attachment repair interventions for both children, their parents as well as our adult clients which can provide corrective experiences and lay out the path to healing.
This is a hands-on, clinical skills-based workshop that uses lecture, experiential exercises and scripted interventions that will be practiced in the workshop.
Workshop Objectives
- Explain to clients how past trauma or loss can lead to ongoing behaviour problems or symptoms using a scripted intervention
- Learn and practice how to do a comprehensive trauma history for adults and for children using a scripted intervention
- Enhance the client’s sense of safety through learning and practicing 5 soothing and grounding techniques
- Understand the mechanisms of trauma resolution, including an introduction to EMDR and Progressive Counting (PC)
- Introduce trauma case consultation format
- Supervision of challenging cases
- Understand trauma’s contribution to reactivity and symptoms by integrating recent advances in neurobiology including Porges polyvagal theory
- Perform an in-depth attachment history to assess attachment wounds and disruption
- Identify attachment symptoms and trauma triggers and understand how this leads to dissociative symptoms
- Describe the EMDR storytelling method within a play therapy context to heal attachment wounds and preverbal traumas
- Utilize and practice attachment repair interventions including Theraplay-inspired games
- Practice three adult repair interventions including Kind Eyes, Loving Resources and Ideal Caretaker.
Target Audience
This workshop is designed for any mental health professionals (or graduate level students) working with children, adolescents and adults in a therapy session. This can include social workers, psychologists, counsellors, school counsellors and any other counselling disciplines. This is a hands-on clinical skills training for working with clients who have been exposed to significant trauma or loss.
Important Note:
- Participants are encouraged to continue with the 8-hour ‘Beyond Trauma 201: After the Basics, Understanding Dissociation Strategies’ workshop.in order to have the full benefit of the full series.
- Participants with little or no experience, and are interested to work with clients on other coping skills (ie, not working on Attachment and Dissociation issues) are encouraged to register for the ‘Post-Trauma Support’ workshop.
Duration
8 hours via Zoom. Due to time difference between USA and Singapore, this workshop will be conducted in the mornings (Singapore Time)
Workshop Topics:
Part 1
- Introduction to Trauma and Phase Model of Treatment
- Case Formulation
- Practice: Trauma History for both adults and children
- Window of Tolerance
- Introduction of Soothing and Grounding Tools
- EMDR and Progressive Counting
Part 2
- Polyvagal theory and implications
- Attachment theory
- Practice: Attachment Questionnaires
- Attachment Scales
- Practice: 3 adult and one child repair intervention
- Practice: Additional soothing and grounding tools
Research Support
The evidence in support of the lifelong impact of trauma has been well established by the ACE study and the research which has followed it (Felitti, et al, 1998). The comprehensive phase model of trauma-informed treatment was developed based on years of research support from Pierre Janet, Judith Herman and more recent work by Cloitre (2021), van der Hart (2005) and EMDR researchers with children including Greenwald. (Greenwald, 2002, 2009, 2013). A phase model with 1) robust case conceptualization and psychoeducation for the client, 2) somatic and mindfulness-based strategies for regulation and 3) when ready, trauma exposure work to reprocess the trauma, are the foundation of all the current evidence-based trauma treatments. Our goal is to provide examples of adaptation of proven-effective methods to real-world situations, and providing a systematic guide to every step of treatment for the therapist based in the community.
We have relied on the published work of other experts in the field of trauma and dissociation to develop the sequence of interventions we are teaching. Additional supportive material related to the neurobiology of attachment comes from Laurel Parnell ( 2013), Stephen Porges (2011), Philip Manfield (2010), Joyanna Silberg (2012) and established and innovative approaches to conceptualizing and intervening with dissociation (Van der Hart, et.al, 2005, Waters, F. , 2016).
Bibliography
Badenoch, B. (2008) Being a Brainwise Therapist: A Practical Guide to Interpersonal Neurobiology.New York: Norton.
Cloitre, M. (2021) Complex PTSD: assessment and treatment, European Journal of Psychotraumatology,12:sup1, DOI: 10.1080/20008198.2020.1866423
Felitti, Vincent J; Anda, Robert F; et al. (1998). "Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study". American Journal of Preventive Medicine. 14 (4): 245–258.
Ecker, B., Ticic, R., & Hulley, L. (2012). Unlocking the emotional brain: Eliminating symptoms at their roots using memory reconsolidation. NY: Routledge
Greenwald, R. (2009) Treating Problem Behaviors. New York: Routledge.
Greenwald, R. (2013) Progressive Counting within a phase model of trauma-informed treatment.London: Routledge.
Greenwald, R. (2002b). Motivation-adaptive skills-trauma resolution (MASTR) therapy for adolescents with conduct problems: An open trial. Journal of Aggression, Maltreatment and Trauma, 6. 237-261.
Hughes, D. (1998) Building the Bonds of Attachment: Awakening Love in Deeply Troubled Children. Lanham, Maryland: Jason Aronson Publishing.
Herman, J.L., Harvey, M.R. Adult Memories of Childhood Trauma: A Naturalistic Clinical Study. J Trauma Stress 10, 557–571 (1997). https://doi.org/10.1023/A:1024889601838
Herman, J. L. (2002). Recovery from psychological trauma. Psychiatry and Clinical Neurosciences, 52(S1), S105–S110. https://doi.org/10.1046/j.1440-1819.1998.0520s5s145.x
Knipe, J. (2009). Back of the head scale (BHS). In M. Luber (Ed.), Eye movement desensitization (EMDR) scripted protocols: Special populations(pp. 233-234). New York, NY: Springer.
Mahler, K. (2015) Interoception: The Eighth Sensory System. Kansas: AAPC Publishing.
Manfield, P. (2010) Dyadic Resourcing: Creating a Foundation for Processing Trauma. California: Createspace Independent Publishing.
Ogden, P. & Fisher, J. (2015) Sensorimotor Psychotherapy. New York: Norton.
Parnell, L. (2013) Attachment-focused EMDR: Healing Relational Trauma. New York: Norton.
Porges, S. (2011) The Polyvagal Theory. New York: Routledge.
Silberg, J. (2012) The Child Survivor: Healing Developmental Trauma and Dissociation. New York: Routledge.
van der Hart, O., Brown, P. & van der Kolk, B.A. Pierre Janet's treatment of post-traumatic stress. J Trauma Stress 2, 379–395 (1989). https://doi.org/10.1007/BF00974597
Van der Hart, O. Nijenhuis, E. , & Steele, K. (2005). Dissociation: An Insufficiently Recognized Major Feature of Complex PTSD, Journal of Traumatic Stress, 18 (5).
Waters, F. (2016) Healing the Fractured Child: Diagnosis and Treatment of Youth with Dissociation. New York: Springer.
Online resources:
- International Society for the Study of Trauma and Dissociation. (ISSTD) http://www.isst-d.org
- Trauma Institute/Child Trauma Institute http://www.childtrauma.com