Every outpatient and inpatient mental health setting, child protection service, parenting program, domestic violence shelter, school, and homeless shelter today must contend with the issue of a past history of exposure to trauma in their clients.
Grant applications and federal funding sources insist that programs become “trauma-informed”. But how can professionals – some with extensive professional training, and some with very little formal training – address the issues that arise surrounding past abuses and exposure to violence without “opening up a can of worms”?
The S.E.L.F. Psychoeducational Group Curriculum is a good way to start, addressing the fundamental problems surrounding exposure to violence without needing to focus on specific individual events within a group setting.
The most elementary aspect of becoming trauma-informed is education. Trauma recovery begins with psychoeducation. Educating people about the impact of overwhelming life experience helps to get everyone “on the same page” with a shared and coherent organizing framework that does not stigmatize the injured person but instead allows a much closer and empathic understanding between client and caregiver.
Unlike most of the theoretical jargon that informs so much of mental health treatment, educating people about the psychobiological effects of serious, recurrent, and chronic stress “rings bells” for them. Even people with little education can easily grasp very complex concepts because the concepts are consistent with their own experience. Much of educating people about trauma is simply giving them words for what they already know and helping them see patterns where no patterns existed for them before.
S.E.L.F. is not a staged treatment model, but rather a nonlinear method for addressing in simple words, very complex challenges. Victims of overwhelming life experiences have difficulty staying safe, find emotions difficult to manage, have suffered many losses and have difficulty envisioning a future. As a result, they are frequently in danger, lose emotional control or are so numb that they cannot access their emotions, have many signs of unresolved loss, and are stuck in time, haunted by the past and unable to move into a better future.
The four concepts: Safety, Emotions, Loss, and Future represent the four fundamental domains of disruption that occur in a traumatized person’s life and within these four domains, any problem can be categorized. Naming and categorization are the first steps in making a problem manageable.
The S.E.L.F Psychoeducational Group Curriculum is designed to provide clients – and staff – with an easy-to-use and coherent cognitive framework that can create a change momentum. Because it is a model that is “round” not square, circular, not stepped, it provides a logical framework for movement. We think of S.E.L.F. as a compass through the land of recovery that can help guide individual treatment, staff decision, team treatment planning, and an entire institution. It is not constrained by gender, age, race, religion, or ethnicity because the domains of healing that S.E.L.F. represents are human universals, unbound to any time, place, or person. In our residential programs, children as young as four are comfortably using the S.E.L.F. language – and using it appropriately.
The S.E.L.F. Psychoeducational Group Curriculum has been almost twenty years in the making. The authors of this curriculum founded The Sanctuary® programs, originally in-patient adult programs to treat complex problems related to a past history of child abuse and neglect and now extended to children’s residential programs, adult substance abuse programs, and a variety of outpatient programs for children and adults.
Our S.E.L.F. groups evolved organically from our need to teach our adult clients how to:
- think differently about their problems;
- organize the changes they needed to make into more manageable bundles;
- help them develop pattern recognition for the ways in which their present problems related to past experiences;
- help provide a roadmap for the process of recovery.
- This curriculum has grown out of that experience and has been adapted to the unique environments that today characterize the mental health and social service world.
- Introductory information, an essay on the Sanctuary philosophy, and a Table of Contents that lists all the available lessons can be downloaded for free at any point. Each individual lesson in the curriculum can then be purchased on-line after signing a licensing agreement that allows a program the right to copy the material but only for that program’s use.
Each lesson includes:
- An Introduction to S.E.L.F. and some S.E.L.F. Group Guidelines
- A Script for a group that focuses on one of the four key topics: Safety, Emotion, Loss, or Future.
- A Handout for the clients to use during or after the group.
- A Resource - written course material for therapists that - taken as a whole - represent an course in trauma studies
For the most part, each lesson is independent of every other lesson and there is no fixed order within which the lessons must be taught. We arranged the curriculum this way for some very specific reasons:
- The turnover rate in many settings is so rapid, that if clients are to benefit from attending only one or two groups, then each group must stand alone as a valuable lesson, without necessitating prior attendance.
- We wanted the curriculum to be responsive to the immediate and pressing needs of each environment at any point in time.
It is not necessary to read the Resource material in order to have the groups be beneficial. However, we believe that as staff members watch the outpouring of new information that will inevitably arise from the group process, their curiosity is likely to be stimulated and we wanted some material to be readily available to them. In some of the lessons we have also suggested some relevant movie titles pertaining to the topics.
Although this is a trauma-informed curriculum, we do not frequently address head-on the issue of trauma, maltreatment or abuse. Again, this was intentional - words like "trauma" and "abuse" are highly charged for many people and are frequently misunderstood. We focus instead on the results of exposure to trauma - experiences that everyone can relate to, whether they have been traumatized or abused in the past or not :
- loss of safety
- inability to manage emotions
- overwhelming losses
- a paralyzed ability to plan for or even imagine a different future
Likewise, many of the lessons can be used for family groups without the need to create an atmosphere of recrimination, guilt or accusation.
Finally, we recognize that the staff members in most mental health and social service environments are stressed, frequently demoralized, frustrated, and overburdened. Many of the direct line staff - and in many cases the professionally trained staff - have little if any experience in running groups and may be intimidated by the prospect of using a group format.
Unfortunately, failure to create a safe group atmosphere wastes an enormous human resource for positive change. Recognizing this dilemma, we have tried to create scripts for group leaders that will create an interactive but contained process, even while opening up painful subjects. Using an educational format - that includes handouts, flipcharts, a question-and-answer format - promotes a containing environment quite different from a typical process group that can be far more difficult to manage. In this way, staff members can discover the power of the group process in helping people to learn, grow and change, while simultaneously building community within their setting.
S.E.L.F: A Nonlinear Organizing Framework
Outline of S.E.L.F. Curriculum
Link to Complete Introductory Material – free download