CHCMHS013 Importance of Gender-Responsive Trauma-Informed Care Assignment Sample

Subject Code : CHCMHS013
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Subject Name : Nursing

Implement Trauma-Informed Care - Part A

A person's need around trauma can be identified or addressed by detecting the type of trauma faced by the person. There are several forms of trauma, such as interpersonal, intergenerational trauma, and others. After identifying the type of trauma and the risk factors associated with it, trauma-informed care must be provided to the patient. The use of trauma assessment tools can identify trauma, and they also help in opting the trauma-informed care that can be given to the patient.
The traumatic events affect both the physical and mental well-being of an individual. These events harm a person biologically, socially, and psychologically. For example, the patients of trauma have body pain, muscle aches, insomnia, sleeping difficulty, fatigue, muscle tension, and a racing heartbeat. They have psychological problems such as shock, anger, anxiety, mood swings, depression, and confusion. These people are socially isolated and are unable to make efficient social interactions with other people (Blue Knot Foundation, 2018).
(a) An individual support plan must recognize the impacts of trauma on the patient's mental, social, and physical health. This can be ensured by understanding the range of threats that are prevented by the use of individual support plans. Detecting the symptomatic expressions of trauma and identifying the interventions for treating trauma also ensure that the individual support plan can recognize trauma or not (NHISSC, 2009).

(b) The considerations regarding the development of individual support plans are that counselling sessions, housing services, and a psychologist must be involved in this plan. This is because the psychologist will help the patient is dealing with the mental and social issues caused due to traumatic events. The housing services will provide a safe environment for the patient, which will improve the chances of recovery from trauma (NHISSC, 2009).

(a) The restrictive practices such as seclusion, restrain, and programs such as compulsory treatment lead to retraumatization. This is because these policies and programs form flashbacks of the traumatic events. Flashback is defined as the process of re-experiencing past traumatic experiences. The patient has to forcefully remember the traumatic events in the form of flashbacks during the implementation of these policies and programs (Batemean & Henderson, 2013).

(b) The impact of programs and policies that lead to retraumatization can be minimized or reduced by using trauma-informed care for treating the patients. The aim of using trauma-informed care is to prevent flashbacks that patients can experience during treatment. Moreover, the use of such programs and policies should be minimized or avoided. These programs and policies should be replaced with evidence-based practices and trauma-informed care methods (Batemean & Henderson, 2013).

According to Yoo et al. (2018), the patients who suffer from interpersonal trauma are at higher risk of committing suicide and self-harm than the ones who have other forms of trauma. The interpersonal trauma moderates self-harm and self-harm leads to suitability. Interpersonal trauma is dependent on personality, and thus, people with poor personality attributes are more prone to self-harm and suicidality. This is the link between self-harm, suicidality, and interpersonal trauma.
The connection between mental illness and trauma can be understood by analyzing the relationship between the causes of trauma and the symptoms of mental issues. The effects of traumatic events are factors that lead to mental or psychiatric disorders such as anxiety and depression. For example, experiencing flashbacks, nightmares, fear, and depression due to traumatic events reflect that the person is having mental issues (Womens Health, 2018).
(a) The caregiver can face many emergencies while working with suicidal and self-harming traumatized patients. Some of these situations are patient is not getting under-control, has become violent and can get panic attacks. The patient is not coping up with the caregiver and can even harm the people nearby.

(b) The caregiver should try to handle the situation calmly and with care. The caregiver must not take any violent or harmful steps to control emergencies. Moreover, the caregiver can take assistance from other caregivers to manage the patient and to prevent the violent actions that the patient can take during these situations.

(a) The communication skills that can be used when the client is in distress are paraphrasing and probing questions. Using strength-based practices that improve patients the strength to cope up with distress is also helpful while treating such patients. The caregiver should build a healthy and safe environment around the client by talking about the patient's strengths.

(b) The patient's distress reflecting a traumatic event can be managed by following the guidelines of trauma-informed care. The patients suffer from trauma-related depressions must be provided with a safe environment and trauma-informed care. Moreover, the caregiver should try to show interest in the patient's traumatic story as it will build trust between them.

Implement Trauma-Informed Care - Part B

The three ethical and legal considerations related to the given case study are as follows:

Discrimination: Hanan and Madina have faced discrimination as they did not get protections from the Government of Afghanistan.
Human rights: The rights of every human that are related to safety and protection have been breached in this case study.
Mandatory Reporting: Hanan and Madina were not able to report the harmful incidents that happened with them.

The people of general community discriminate against the people who have experienced traumatic events.
The general community can have the belief that people having cumulative trauma can be a threat to them as they have psychological disorders.
The general community can have the belief that it is difficult to provide care to the patients having cumulative trauma.

(b) These beliefs and negative attitudes that have a negative impact on the people who have cumulative trauma. This can cause depression and can worsen the well-being of the trauma patients. Moreover, the patients of trauma can find it difficult to access help and other services from the general community.

As per the Mental Health Coordinating Council (2013), the triggers and flashbacks that can be experienced by Hanan and Madian are as follows:

Images of the war: The people who have witnessed war generally get flashback images of war.
News and articles or other visual stimuli can act as triggers of war as they can cause re-traumatization.

Not involving any negative comment on the culture of Afghanistan as it is culturally incompetent.
Taking about the positive thinking and beliefs of the client's culture.
Ensuring that the questions asked to the client are not reflecting disrespect towards the client's cultural beliefs.

The people who have experienced loss and grief due to traumatic events related to wars are less impacted due to future traumas than the people who have never experienced trauma. They have the capability of controlling themselves when they experience future loss of family members. These people are also able to live better in adverse conditions than the people who have not experienced loss and grief.

The feedback about the impact of trauma must be collected in a cultural and age-sensitive way. It can be in the form of closed questions and a one-word answer form. The feedback must be based upon the patient's interpersonal beliefs, and the patient should have the opportunity to give answers in a particular way. For example, the feedback collected by the Afghanistan family experiencing trauma must involve questions related to Afghanistan values, and it must be connected to their age (NHISSC, 2009).

Include positive reactions: They must get positive and supportive reactions when they are disclosing their trauma stories.
Use polite words: The use of words such as "I understand" and " I am with you" provide support to the trauma patients.
Reacting with belief: The trauma patients, while disclosing their trauma stories, must not sense disbelief as this affects their health and builds insecurity.
Responding with equality: The patients of trauma must be provided with a feeling that they are equal, like other people.
Do not interrupt them: The trauma stories of the patient must be heard carefully and with utmost involvement as it builds trust between the caregiver and the patient (Good Therapy, 2017).

Implement Trauma-Informed Care - Part C

The three rights and ethical considerations related to this given case study are:

Human rights: All people have the right to live safely, but in this case, Bob has to live in an unsafe environment with a threat of losing a life.
Work, health, and safety: Bob in the given case study had experiences of physical and sexual abuse, which reflect an unhealthy and unsafe environment.
Mandatory reporting: In this case, Bob has not reported the sexual and physical abuse experienced by him to any organization or help centres.

(i) The people are not supportive of the victims of sexual and physical abuse. Moreover, they discriminate against them due to these traumatic events.

(ii) The general community has a belief that people with experiences of physical and sexual abuse are unequal or inferior to them.

(iii) The general community does not provide respect to the victims of these traumatic events.

(b) These beliefs and attitudes of the general community can have a negative effect on the people suffering from physical and sexual abuse. This is because they are not able to get a safe environment around them. Moreover, they live in a state of fear and face discrimination and inequality. These beliefs and attitudes can cause mental disorders and can force them to attempt suicide and self-harming activities.

(i) Reading newspaper articles and reports related to physical and sexual abuse can cause flashbacks of such events, and this can result in retraumatization.

(ii) Viewing any form of sexual or physical abuse by the victim can also lead to retraumatization.

Trauma-informed care must be gender-specific. This is because the trauma that is faced by women is generally different than the trauma suffered by men. Moreover, the ways in which women react to trauma-informed care is different from the ways in which men respond to this care. For example, trauma-informed care for women is generally based on sexual abuse and physical violence. However, trauma-informed care for men is related to preventing substance abuse (Women's Health Research Institute, n.d.).
Interpersonal violence increases the chances of trauma. This is the relationship between interpersonal trauma and violence. The people who face violence from known ones develop trauma more quickly than the ones who experience violence from strangers. This is the reason that the chances of trauma get high due to interpersonal violence.
As per NHISSC (2009), the avoidance of potential harms from an environment is termed as safety. A safe relationship can be built between the caregiver and the client by promoting safety. Safety can be developed by building a safe and secure environment around the client. This can be done by improving the client's strengths, creating a sense of community, reviewing the plans and services and taking feedbacks from the client, implementing self-care practices, identification of emergencies to avoid potential harm, and respecting the client.
As per NHISSC (2009), the following three ways can be used to check whether the community services are meeting the needs of the client or not:

(I) Clients must be asked questions related to the community services that are provided.

(ii) The effect of community services must be checked through recovery rates. This helps the caregiver in understanding whether the services are effective on the patient or not.

(iii) Using trauma-informed assessment tools can identify whether the community services provided to the client are effective or not.

(i) James: He can be recommended to Phonix Australia, an Australian organization that provides care and support to the patients having mental health trauma. James has witnessed both physical and sexual abuse, which can lead to mental trauma. This organization can help James in recovering from mental health trauma as it is a centre for posttraumatic mental health. The victims of all kinds of trauma can take help from this organization (Phoenix Australia, 2019).

(ii) Sophia: Sophia has seen Bob physically abusing James, and this can cause mental disorders in her, such as fear and depression. Thus, Sophia can be recommended to the Australian Childhood Foundation, an Australian organization that provides care to the children affected by traumatic events. All children who have faced traumatic events or are facing such events are eligible to take support from this organization (Victoria State Government, 2017).

The caregiver must ensure that the client is being referred to a good trauma organization that can provide apt trauma-informed care and services. The client must be provided with the details of the organization that is being referred to. Moreover, valid consent must be taken from the client before sharing the client's information to the organization that is being referred to (NHISSC, 2009).

(a)

Mention the traumatic events and the impacts of trauma on the client to the organizations to which the client is being referred to.
Involve the family members and the client in the referral plan. A valid consent should be taken from the client before sharing the information with the referral organization.
Make the client understand the importance of referrals and the reason why the referral is being made.
The client must be referred to as the services and organization that provide a safe environment (Health Care Toolbox, 2016).

(b) It is important to follow up the referrals to track the recovery state of the patient. The caregivers must take feedbacks from both the client and referral agencies to identify whether the referral is a success or not. These referrals should be taken regularly to check the impact of referral services on the health of the client.

References for Implement Trauma-Informed Care

Bateman, J. & Henderson, C. Mental Health Coordinating Council (MHCC). (2013). Identify how general and mandated services can impact a client with triggering trauma and re-traumatising a person. Retrieved from https://www.mhcc.org.au/wp-content/uploads/2018/05/nticp_strategic_direction_journal_article__vf4_-_jan_2014_.pdf

Blue Knot Foundation. (2018). Impacts: What are the impacts of child abuse and childhood trauma? Retrieved from https://www.blueknot.org.au/Resources/Information/Impacts-and-healing/Impacts

Good Therapy. (2017). How not to react when survivors of sexual trauma disclose. Retrieved from https://www.goodtherapy.org/blog/how-not-to-react-when-survivors-of-sexual-trauma-disclose-0828175

Health Care Toolbox. (2016). When and how to refer to mental health care? Retrieved from https://www.healthcaretoolbox.org/what-providers-can-do/when-and-how-to-refer-for-mental-health-care.html

Mental Health Coordinating Council (MHCC). (2013). Trauma-Informed Care and Practice: Towards a cultural shift in policy reform across mental health and human services in Australia, A National Strategic Direction, Position Paper and Recommendations of the National Trauma-Informed Care and Practice Advisory Working Group. Retrieved from www.mhcc.org.au/wp-content/uploads/2018/05/nticp_strategic_direction_journal_article__vf4_-_jan_2014_.pdf

National Health Information Standards and Statistics Committee (NHISSC). (2009). The National Health Performance Framework. Retrieved from https://www.aihw.gov.au/reports-data/australias-health-performance/australias-health-performance-framework

Phonix Australia. (2019). Traumatic stress research clinic. Retrieved from https://www.phoenixaustralia.org/expertise/research/clinic/

Victoria State Government. (2017). Stress and trauma in young children - workshops. Retrieved from https://www.education.vic.gov.au/childhood/professionals/profdev/Pages/expired/stress-and-trauma-young-children.aspx

Women's Health Research Institute. (n.d.) The importance of gender-responsive trauma-informed care. Retrieved from https://www.womenshealth.northwestern.edu/blog/importance-gender-responsive-trauma-informed-care#:~:text=Ensuring%20that%20trauma%2Dinformed%20care,to%20trauma%20in%20different%20ways.&text=This%20is%20because%20mental%20health,often%20co%2Doccurring%20among%20women.

Womens Health. (2018). Abuse, trauma, and mental health. Retrieved from https://www.womenshealth.gov/mental-health/abuse-trauma-and-mental-health

Yoo, Y., Park, J. H., Parl, S., Cho, J. M., Cho, J. S., Lee, Y. J., Choi, H. S. & Lee, Y. J. (2018). Interpersonal trauma moderates the relationship between personality factors and suicidality of individuals with posttraumatic stress disorder. PLoS ONE, https://doi.org/10.1371/journal.pone.0191198

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