TRAUMA & MENTAL HEALTH FAQs

Interview with Dr. Sarah Williams, LPC, NCC, ACS & Hilary Roberts, Founder of the Red Songbird Foundation

What is trauma?

(Dr. Williams) Trauma is characterized as the after experience of a distressing or life- threatening event. The experience can be Acute: one event (911), Chronic: a series of events (Domestic Violence), or Complex: multiple life threatening or distressing events (Abuse, Victim of Crime, Poverty).

(Hilary Roberts) Trauma for children is behavior towards children is anything less than nurturing. Overt abuse is yelling, name-calling, hitting, violating. Covert abuse is passive aggressive behaviors…ie ignoring.

I experienced yelling, name-calling, and some violence.

I was sexual abused starting since I can remember, by different perpetrators, and when I told about some, I was not believed.

I also remember if I did something to upset one of the adults raising me, they would withhold affection, and become passive-aggressive.

As a child, I was abandoned for a time.

What is mental health?

(Dr. Williams) There are several dimensions of health (Physical, Spiritual, Social, Environmental, and Mental Health). Our Mental Health encompasses a complex interaction of emotional reactions and processes. Occupational, Interpersonal, Environmental, and Social experiences impact our Mental Health.

(Hilary Roberts) Mental Health is the realization of your internal value of worth. It is the absence of shame. 2b) Active treatment of mental disorders- when a person needs medication and they follow Drs instructions to stay stabilized.

So much of my life was about not feeling lovable, worthy, or that I had value, and I reacted to that belief about myself by acting out in self-demeaning behaviors, which incited more trauma. Also, I allowed people to abuse me and use me, because of what I had grown up experiencing and living in.

What to do when a loved one is struggling? (1st step)

(Dr. Williams) The first step is to offer support. Using empathetic listening, approach your loved one to find out how you can help.

(Hilary Roberts) Be supportive and loving, and present solutions that could be helpful. Such as treatment, therapy, information, and introduction to those that have struggled before and are now doing well.

When I was in so much pain and shame, there were beautiful people that made loving suggestions and recommended different solutions that they had used before and that they were much happier. For those that were concerned, but had never walked through what I had, they shared information and introduced me to those that could help. But, I wasn’t willing right away, as I didn’t trust anyone. It took time to seek help and accept and utilize the tools.

What are signs and symptoms that you are experiencing to show that you are struggling with trauma or mental health?

(Dr. Williams) Although there are variations in how one may express if they are struggling with trauma or mental health, symptom to look for if you are struggling include difficulty with work or career responsibilities, relationships, and/or managing household responsibilities. In addition, physical illness (migraine/headaches, stomach upset, difficulty with sleep), poor coping with minor stressors, isolation, and problems with experiencing contentment or joy are common symptoms associated with mental health struggles. Specific to trauma, if there is an adversary response (trigger) that occurs and results in an adverse emotional reaction and/or interruption in routine this is an obvious sign of a trauma associated struggle.

(Hilary Roberts) Experiencing nightmares, flashbacks, being triggered by situations that remind the person of their trauma, can’t control emotional responses, not being able to live in the moment because a person is so affected by what happened in the past, the use dysfunctional behaviors, such as food, sex, shopping, alcohol/drugs, anxiety behaviors.

“If it’s hysterical, it’s historical”-Pia Melody

When someone has clear symptoms of mental health but won’t get help, what do you do? (Even if they are not a threat to themselves/society).

(Dr. Williams) If someone is clearly struggling however will not get help you can

1. Allow them the opportunity to express why they are reluctant to get help.

2. Provide non-judgmental/caring support with healthy boundaries.

3. Provide them with a resource or referral phone number and encourage them to pursue available help.

4. Closely monitor their condition and make appropriate contact with medical personnel if there is a decline, particularly if they become a danger to themselves or others.

(Hilary Roberts) You can voice your concern to them, but codependency recovery teaches us to live our lives and let them live theirs. Until they are ready to take action, there isn’t much we can do.

*If someone is at risk of harming themselves or others, call 911 and get them help. Also, there is the National Suicide Hotline 800-273-8255.

When is an intervention needed and what should it look like?

(Dr. Williams) An intervention is in essence a circle of “emotional stakeholders” (friends, family, etc.)  that are interested in assisting a person make an informed decision to receive treatment. It is recommended that the intervention include a trained Interventionist. A plan should be prepared and in place prior to commencement of intervention to streamline process of entry to treatment.

(Hilary Roberts) An intervention is needed/chosen when loved ones, friends and co-workers are fearful about an individual’s well-being and/or life. It also helps the concerned parties know that they tried to help.

What do you do when someone will not be medication compliant?

(Dr. Williams) Initially you should determine the gravity of the non-compliance. For instance, if the person is a danger to themselves or others as a result of the non-compliance you should contact emergency services. If an immediate danger does not exist then attempt to determine the rationale for medication non-compliance. In addition, you can offer to assist individual with overcoming barriers. For example, helping person establish reward system for compliance or assisting them with setting up an alert for reminder to take medication. Encouraging a talk with medical provider about their challenges may be beneficial as well to someone that is not medication compliant.

(Hilary Roberts) You can talk them about it, but we cannot force other people to do what they need to do. Again, if they are suicidal or a threat to others, call 911 and/or use the suicide hotline 800-273-8255.

How do you vet trauma/mental health treatment?

(Hilary Roberts) It is good to get a mental health providers recommendation. Most mental health providers know which facility would work best for the client.

A doctor or therapist usually knows great facilities. Also, looking at reviews is good. A facility that puts mission over margin. Word of mouth is usually reliable. Talking to people that have already been though the process and are finding relief and living happier lives. I would never recommend a facility that doesn’t look at family of origin issues.

What should trauma treatment provide and look like?

(Hilary Roberts) A facility or therapist/doctor that has family of origin treatment. They have a great psychiatrist on staff that is educated and knowledgable in the areas of trauma, addiction, mental health. A good family program for the family members, they have a “family week”. Education about the disease concept. I recommend 12 step based facilities, that encompass mental, emotional, psychological and physical health. Most of the time, one affects the other.

What clinicians should oversee the case and what should their qualifications be?

(Dr. Williams) MD/Psychiatrist, Licensed Psychologist, Licensed Mental Health Therapist or Clinical Social Worker, Case Manager, Art/Music Therapist, and Holistic Practitioners.

(Hilary Roberts) They should be a trained and licensed professional.

Should a case manager be available?

(Dr. Williams) Yes, a case manager should be available. The role of the case manager can be a vital aspect in Aftercare that supports recovery.

(Hilary Roberts) Any good facility would always have a case manager.

What is the role of a therapist?

(Dr. Williams) The role of a therapist is to assist and accompany a client in the journey for change.  Therapists give support by showing empathy, being genuine, and offering space for clients to lead their own treatment process.  What is most important is that the therapist is willing to meet the client wherever they are on their journey for healing, change, and overall improved lifestyle.

(Hilary Roberts) It is to educate, to show the client how to implement helpful tools to use, to provide empathetic understanding, absolute confidentiality, but to be willing to reach out if somebody is at risk of self harm or a danger to others.

What are different therapeutic modalities that are used?

(Dr. Williams) Therapists should be flexible in choosing counseling modalities. Therefore, a combination of techniques can prove to be most effective in supporting clients. Current and Effective Modalities Used include, Cognitive Behavioral Therapy, Client Centered Therapy, Motivational Interviewing and Dialectical Behavior Therapy.

(Hilary Roberts) There are many modalities. My preferred modality is Pia Melody’s modality of healing the wounded child.

What are most current and effective modalities currently used? (If listed, please source)

(Hilary Roberts) Trauma based therapy, Cognitive Behavioral therapy, Positive Behavioral therapy, Reality therapy, EMDR, Pscho-Drama therapy, Pscho-analysis, Equine Therapy, and Art Therapy.

What should a family program look like, if any?

(Hilary Roberts) There should always be a family program. It should be education, awareness of what trauma and mental health issues look like, very important to treat co-dependant behaviors, and should include 12 step programs such as Al-Anon.

How can the family best support themselves and the individual that’s struggling?

(Hilary Roberts) Learning,understanding and practicing good self-care.

What does a solid aftercare program look like?

(Hilary Roberts) There will be a treatment plan which will include having a therapist and/or psychiatrist they will see consistently, have planned recovery meetings (many are 12 step based), possible medication, having a sponsor/mentor/accountabilty persons.

Is monitoring necessary, if so, what should it look like?

(Hilary Roberts) Their aftercare will include the professional doctor/therapist that they will see and will be the one monitoring them.

What are natural highs and how can you obtain them?

(Hilary Roberts) Support community, having a healthy community of people that you do fun activities with, Exercise, going outside, going into nature, nutrition, spiritual practices.

What’s the best way to maintain mental well-being?

(Hilary Roberts) When the client adheres to their aftercare program and takes the actions recommended. To do EVERYTHING that has been recommended and implement those tools as a way of life. Nothing changes, if nothing changes.

Anything else that someone should know or be equipped with when dealing with trauma/ mental health?

(Hilary Roberts) Dont be afraid to work on your trauma.It is better to be in pain, recovering, than to stay in the same hell. It is a process. Walk though the fire to get to the freedom and joy. The beautiful freedom I have gotten from doing the work, is amazing. That is why I founded Red Songbird Foundation. Because I want others to experience the same freedom that I have had. You can do this, you can recover, and you can have joy and freedom. Sending love and hugs , Hilary

Trauma & Mental Health FAQs Courtesy of Dr. Sarah Williams, LPC, NCC, ACS

To learn more visit www.covenantwaywellness.org