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Neami National
Neami’s Services in the Inner City/ Eastern Suburbs
Presented by:Lise Kjaer – Service ManagerAlex Sturman – Peer Support WorkerGerhard 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 child’s relationship with a caregiver, they interfere with the child’s 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.
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 crisis-
challenge-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
Neami’s ValuesConsumers, staff and committee have defined
the values which drive Neami’s Recovery Vision as:
• Wellbeing• Learning• Quality• Empowerment• Partnerships• Acceptance of diversity
• Choice• Self Determination• Respect• Hope• Growth• Change
Coaching Style Relationship
Optimal Health[OHP]
Hope Theory
Strengths BasedApproach
Collaborative Recovery
Model[CRM]
Wellbeing
Experiential Narrative
Autonomy andSelf Efficacy
Collaborative Recovery
DefinitionsLife 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 contextAction Plan = A plan of actions to take to reach the target level of goalCoordinates = 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 what’s 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 consumer’s 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.
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
TIC Framework
• 3) Integration: our focus is on recovery in accordance with individual’s 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
