Neami National Neamis Services in the Inner City/

Neami National Neamis Services in the Inner City/

Neami National Neamis Services in the Inner City/ Eastern Suburbs Presented by: Lise Kjaer Service Manager Alex Sturman Peer Support Worker Gerhard Bronn Community Rehab and Support Worker (former Peer Worker) Neami Darlinghurst Neami National National NGO Mental Health Organisation

Provides Rehabilitation & Recovery Support to people with a mental illness who require assistance in the areas of skill development, social contact & housing. Mission Statement & Vision Improving mental health & Wellbeing in local communities. Full citizenship for all people living with a mental illness in Australian society Complex Trauma

We assume that every consumer we work with has complex trauma: exposure to multiple traumatic events, often of an invasive, interpersonal nature, and the wide-ranging, long-term impact of this exposure Adverse Childhood Experiences (ACE): are severe and pervasive, such as abuse or profound neglect. They usually begin early in life and can disrupt many aspects of the persons development and the very formation of a self. Since they often occur in the context of the childs relationship with a caregiver, they interfere with the childs ability to form a secure attachment bond.

Disorganised attachment style There is a clear and consistent relationship between disorganised attachment style and complex trauma When the fight-flight system is activated in these individuals two incompatible systems are simultaneously activated that lead to unhelpful thinking, feeling and behaviour.

Biological conflict between survival and attachment, go away from and go towards the same person. Attachment Styles Window of Tolerance Indicators of Trauma: Hyperarousal: over activation of CNS: hypervigilance,

increased sensation, intrusive imagery and disorganised cognitive processing. Hypoarousal emotional numbing and shut down. TIC: staying within the window of tolerance with our crisischallenge-comfort zones (consumer friendly) Window of Tolerance Trauma Informed Care (TIC) Unrecognised trauma is psychologically, financially and systemically costly TIC is used to prevent the merry go round of unintegrated care that

risks re-traumatising and compounding unrecognised trauma TIC is imbedded in the service delivery of Neami National We aim to provide care that is integrated with clear referral and follow-up pathways Intake and assessments are inclusive, avoid interrogation and excessive paperwork Neamis Values Consumers, staff and committee have defined the values which drive Neamis Recovery Vision as:

Wellbeing Learning Quality Empowerment

Partnerships Acceptance of diversity Choice

Self Determination Respect Hope Growth Change Autonomy and Self Efficacy Experiential Narrative

Coaching Style Relationship Optimal Health [OHP] Collaborative Recovery Wellbeing

Collaborative Recovery Model [CRM] Hope Theory Strengths Based Approach Definitions Life Vision = A verbally stated description of what one calls their envisioned life that contains

their identified values and strengths or overall life purpose e.g. if you have a photo album of your values and strengths, what would you call your life album? Preferred Identity = How you would like others to see you, and how you would like to see yourself. Preferred relationship with self, others and the world. Valued direction= Life directions towards which you are typically trying to orient yourself in your daily life, not specific, not time framed, ongoing (alignment) e.g. to improve my relationships with others Strengths = A value that has been dependably demonstrated or a talent that has been developed Goal = Specific, measurable, desired endpoint, with a timeframe (focused target narrow lens)

Action = A tangible behavior in a specific context Action Plan = A plan of actions to take to reach the target level of goal Coordinates = The Collaborative Goal Index Score, providing a person with a numerical score which weights their progress (vertical) across the three goals (horizontal). Visioning Well Being Experience of well being occurs when whats happening on the inside matches what is happening on the outside Principle Theories

Well being Theory Self Determination Theory Stress Vulnerability Model Stages of Change Model Resilience Hope Theory Consumer Participation Movement Recovery Movement

Self efficacy I can do model Experiential psychological narrative Positive psychology Collaborative Goal Technology Coaching style relationship Parallel process TIC Service Delivery Guidelines Flexible inclusion criteria Attune to attachment issues at all times and from the first point of contact

Facilitate client safety and stabilisation (model secure attachment style while maintaining boundaries of relationship) Strengths based approach that empowers the consumers existing resources Fostering person-centred approaches to recovery; one size does not fit all TIC Service Delivery Guidelines Consistent service across different sites and team members Aware that complex trauma requires frequent support over an extended period of time celebrating small victories are

important to sustain motivation Recognise the importance of implementing appropriate boundaries (e.g. friendly versus friends) and modelling secure relationship communication styles Engage in collaborative care when appropriate Persevere! TIC Framework 1) Stabilisation and safety: respect and strengths focus and being attuned to ACE (Adverse Childhood Experiences) and

attachment issues. Perseverance. Case example of initial rapport building. TIC Framework 2) Processing: boundaries (friendly vs friends) and collaborative care (CRM tools), MI, coaching and mentoring. Flourish and Peer component, refer on to trauma counselling if required (e.g. ASCA) Case example

TIC Framework 3) Integration: our focus is on recovery in accordance with individuals strengths and values. Camera, Good Life Album, Flourish and recovery groups. Explore vulnerabilities and strengths in safe environment self directed pathways to recovery. No end goal, fluctuating process, ACT. Case example Summary

Neami National integrated TIC into service delivery framework TIC is reflected in flexible inclusion criteria Attunement to attachment styles Strengths based, consumer driven approach, whilst maintaining appropriate boundaries Hope, persistence and perseverance Contact Us Neami National Darlinghurst Phone: 02-9380 9629

Email: [email protected]

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