1. technology and computing
2. data centers

 Bill Cross PhD LMFT Moral Injury •  …is the damage done to one’s conscience or moral compass when one perpetrates, witnesses, or fails to prevent acts that transgress one’s own moral and ethical values/codes of conduct/understanding. www.communityresiliencymodel.com www.traumaresourceinsEtute.com Trauma Resiliency Model™ Adapted by Elaine Miller-­‐Karas from the original work of Elaine Miller-­‐Karas and Laurie Leitch The Trauma Resource Ins5tute A Nonprofit CorporaEon Our Vision To create resiliency informed and trauma informed individuals and communiEes. Our Mission A commitment to bring wellness skills, based on cuNng edge neuroscience, to our world community, one person at a Eme, one community at a Eme. Resilience Resiliency “Is an individual’s and community’s ability to iden4fy and use individual and collec4ve strengths in living fully in the present moment, and to manage the ac4vi4es of daily living.” Miller-­‐Karas (2013) What Are the Two Resiliency Models?
v  The Trauma Resiliency
Model (TRM):
v A skills-based course
for clinicians.
v Focused on
stabilization of the
nervous system.
v Designed to reprocess
traumatic experiences.
6 v  Community Resiliency
Model (CRM):
v  A set of 6 wellness
skills that can be
taught to community
members.
v  Focused on
stabilizing the nervous
system.
v  A triaged system of
care.
What is the Community Resiliency Model? Resilient Zone v  Set of six Wellness Skills v  Resets the natural balance of the nervous system v  Brings awareness to a person’s ability to come back into his or her Resilient Zone Trauma4c/Stressful Event or Stressful/Trauma4c Triggers Resilient Zone Stuck in High Zone Edgy Irritable Mania Anxiety & Panic Angry outbursts Pain Depression/Sadness Isolated Exhaus=on/Fa=gue Numbness Stuck in Low Zone Graphic adapted from an original graphic of Peter Levine/Heller, original slide design by Genie EvereW 8
Resilient Zone Some have a very shallow Resilient Zone where even small stressors bump you out of the Zone. Resilient Zone Some have a deep Resilient Zone where there is a higher tolerance for a wide range of stressors. Who can TRM Treat?
TRM can be used:
v  To treat any person who has survived a
traumatic event where they perceived
threat of death or injury to themselves or
others.
v  With immediate as well as past trauma.
v  To treat complex trauma as well as single
event trauma.
v  For practitioner self care to reduce
burnout resulting from secondary
traumatization.
v  Across cultures.
v  To treat children and adults.
CRM Key Concepts “It is about biology -­‐ not human weakness.” Primary Focus of TRM:
Biology vs. Mental Weakness
v 
Responses to trauma and stress can have a major
effect on the mind, body and spirit.
v 
TRM practitioners use observation and knowledge
of patterns within the nervous system.
v 
TRM helps individuals track sensations connected
to their well-being (their resilience).
An Elegant Design:
The Capacity to Heal
The human body - mind
has the inner capacity to
heal and restore itself and
has a wisdom that words
cannot speak.
There is hope:
the brain is plastic…it is
changeable…
13
Skills of the Trauma Resiliency Model 14
What are the 9 Skills of TRM?*
* TRM includes some of the skills of Somatic Experiencing
TRACKING
Refers to the practitioner’s and client’s monitoring of sensations
RESOURCING & RESOURCE
INTENSIFICATION
Using positive or neutral factors to create
non-traumatic sensations
GROUNDING
Being fully present in the moment
SHIFT AND STAY
Shifting to a resource and staying in the
resource state
TITRATION*
Working with small increments of arousal
GESTURING/SPONTANEOUS
MOVEMENT
Bringing awareness to spontaneous
gestures/movements that are self-soothing
HELP NOW!
Strategies to get back to the R-Zone
15 PENDULATION*
Alternating between traumatic and
resource sensations
COMPLETION OF
SURVIVAL RESPONSES*
Trauma Resource Ins5tute Community Resiliency Model Skills TRACKING
Paying attention to sensations
RESOURCING & RESOURCE INTENSIFICATION Using posiEve or neutral life experiences to create pleasant or neutral sensaEons GROUNDING Being fully present in the moment GESTURES & MOVEMENTS Bringing calming & protecEve movements to awareness SHIFT AND STAY Strategies to get back to R-­‐Zone Shi[ing to a resource and staying in the resource state Trauma Resource Ins5tute HELP NOW!! Community Resiliency Model Skills
THE BASIC THREE TRACKING
Paying attention to sensations
RESOURCING & RESOURCE INTENSIFICATION Using posiEve or neutral life experiences to create pleasant or neutral sensaEons GROUNDING Being fully present in the moment Trauma Resource Ins5tute Developing the Evidence Base
Completed Research
Katrina Study—Journal of Social Work
v  The treatment group showed statistically significant gains in resiliency indicators and
decreases in posttraumatic stress disorder symptoms.
China Study-International Journal of Emergency Mental Health
v  97% believe that biologically-oriented TRM training will be very to moderately relevant
or useful for their work with the Chinese earthquake survivors
Research Underway
v  Preliminary unpublished data showing decrease in depression scores after 3 three 20
minute CRM interventions, delivered over a period of 7 days. Haiti-HelpAge Population
(Citron, Dust & Karas)
v  Loma Linda University, Department of Social Work, Ivory Coast Study
v  County of San Bernardino, TRM-Community Resiliency Model-Innovations and VEP
projects, State of California (Miller-Karas, Citron & Leitch)
v  Family Medicine Primary Care Study. Mary Lynn Barrett, MPH, Family Practice
Residency Program. Asheville, NC
v  El Paso/Juarez Mexico Study, University of Northern Colorado
v  Walter Reed Hospital, study completed
Mental Health Services Act-Innovation Project-2013
v 
v 
v 
From a wide community:
v African-American, Latino, Asian Pacific Islanders,
LGBTQ, Native American and High Risk Youth,
Veterans & ranged in age from 22-75 years.
Statistically significant decreases in:
v The average number of depression, hostility, anxiety,
and somatic symptoms.
Statistically significant increases in the average number
of symptoms related to:
v Relaxed, contented, somatic well-being, and friendly
indicators.
3-6 Month Follow-up
v 
v 
3-6 month follow-up data received from 57 trainees across the
underserved groups indicated that over 90% either completely or
somewhat agree that the CRM skills were useful in:
v  Managing stress (95%)
v  Having better self control (96%)
v  Helping get through hard times (92%)
All used the skills frequently, with 93% reporting they were using the
CRM skills daily, and 7% indicating a few times a week.
20
Trauma Resiliency Model (TRM) Survey Results 8/20/12 v  Collected from the staff of the Department of Behavioral Health, (DBH) San
Bernardino County:
v  Serves the underserved population with mental health challenges within the
largest county in the U.S.
v  Over 500 of their staff (case managers, social workers, counselors, psychologists,
psychiatrists) have been trained by in-house TRM Trainers.
v  The survey was conducted by the training center of DBH to determine the staff’s
perceptions of the usefulness and effectiveness of the Trauma Resiliency Model. (242
Respondents)
90.0%$
80.0%$
70.0%$
60.0%$
50.0%$
40.0%$
30.0%$
20.0%$
10.0%$
0.0%$
83.3%#
76.5%#
61.0%#
39.0%#
16.7%#
Do#you#use#the#
TRM#techniques?#
23.5%#
At#work?#
Yes#
No#
Outside#of#work?#
100.0%$
90.0%$
80.0%$
70.0%$
60.0%$
50.0%$
40.0%$
30.0%$
20.0%$
10.0%$
0.0%$
Do&you&find&TRM&effec8ve?&
91.0%#
3.6%&
Yes#
10.8%&
20.1%&
23.0%&
All&the&8me&
No#
9.0%#
42.4%&
Most&of&the&8me&
Some8mes&
Rarely&
Do#you#find#TRM#useful?#
N/A&
In The Zone How o[en have you been in your Resilient Zone today? Never Occasionally SomeEmes Frequently All the Time 1 2 3 4 5 THE BODY HAS A WISDOM THAT WORDS CANNOT SPEAK WWW.TRAUMARESOURCEINSTITUTE.COM WWW.COMMUNITYRESILIENCYMODEL.COM Slides by MillerKaras&Leitch 2011(c)