Memorial Hospital Becomes ‘Trauma-informed’ to Improve Health
By Les Gura
A growing number of studies in recent years have shown a correlation between multiple adverse childhood experiences and long-term adverse health effects.
To Margo DeMont, PhD, executive director of Community Health Enhancement for Memorial Hospital of South Bend, Indiana, that correlation provided the impetus for an innovative approach to offering a chance at better long-term health to thousands of underserved residents.
Three therapeutic approaches
Memorial Hospital has begun a program that uses three different therapeutic approaches—offering training to dozens of care providers and social workers along the way—in hopes of reaching people in these populations who have suffered through adverse childhood experiences. Without such help, people are more likely to face long-term health problems. These can include drug or substance abuse, but also cardiopulmonary disease, diabetes, obesity and other problems.
“We have to have hope with everything we do,’’ DeMont says. “These programs have impacted and even transformed children or adults. We’re becoming a trauma-informed community.’’
The programs being offered with the help of Memorial are part of partnerships established between the hospital and a YWCA, a residential facility for victims of domestic violence, a community mental health center, a women’s day program, a ministries program, public and charter schools, and more.
Many of the programs now have people trained in Eye Movement Desensitization and Reprocessing (EMDR), an accelerated healing tool for small and large traumas that helps identify barriers individuals of any age face that interfere with their happiness. Other programs are Acute Trauma Incident Processing (ATIP, a specially abbreviated and contained form of EMDR) and cognitive behavioral therapy (CBT). Their common ground is that all focus on traumatic events and allowing people to deal with them with the goal of improving their long-term health.
DeMont says a Community Health Needs Assessment undertaken by Memorial as part of the mandate of the Affordable Care Act showed in South Bend, as in other national surveys, the powerful connection between adverse childhood experiences and longer-term health problems. And the more people experienced trauma when they were young, the more likely they were to face long-term health effects.
As a result, the hospital in 2012 decided to bring outreach to its underserved populations with the specific programs, which began last year. The hospital has continued to expand its outreach by training more and more people to deliver the therapies.
Recovering from trauma
Katie Steele, PhD, is a psychotherapist in South Bend who owns Wellness Associates, a practice that focuses on healing and recovery with a mind-body-spirit perspective. As a longtime practitioner of EMDR, she and her colleague, Crystal Whitlow, LCSW, have already helped train more than 30 people as part of Memorial Hospital’s outreach, with another 20 people set to be trained this fall. The training was led by EMDR veteran Roy Kiessling, LCSW, of Cincinnati, who developed ATIP.
Steele says EMDR can help people recover quickly from a trauma in a different way than traditional talk therapy.
With EMDR, a trained provider takes a person through the trauma experience initially by discussing their feelings during what happened and then performing, via protocol, a series of hand movements and asking the patient to follow those movements with their eyes. After the sequence of movements, the patients are asked to review the intensity of their feelings about the trauma, with the goal of reducing the heightened emotions they typically feel as a result of the trauma.
The goal is to move the information from the incident in their brain (reprocessing) from the right hemisphere, where emotional experiences are locked up, to the left hemisphere, the more cognitive area of the brain.
When people get healthier emotionally, other things get better
People who experience multiple traumas without support can become locked into a “fight or flight” emotional response, reacting out of the right hemisphere of their brain to triggers that the left hemisphere would normally be able to evaluate more rationally. Recurrent trauma frequently leads them to believe the things that happen to them are their fault.
“They perceive their world through a filter of negative experiences,’’ Steele says, “which overlays more negative experiences on. If you can work with a kid, before it gets that embedded as a foundation for their whole life’s brain activity, it can make a huge difference. EMDR moves very, very quickly with kids.’’
But it can be effective with adults, too. “What we’re doing is taking away the trauma reaction so that a normal adaptive belief can be there,” she says.
She believes the use of EMDR, as well as other therapies to address adverse childhood experiences in dealing with long-term health consequences, is long overdue.
“When people get healthier emotionally, lots of other things get better,’’ Steele says. “It’s not just about behaviors, but about the way their systems work. Being able to help at-risk kids and adults with these kinds of things, I think, will have very positive health outcomes.’’