What is Sanctuary? Shay Williams, M.Ed., LPC-S, LCCA.

What is Sanctuary?

Shay Williams, M.Ed., LPC-S, LCCA

FOUNDERS OF THE MODEL: THEN AND NOW

THE SANCTUARY MODEL

In a nutshell…..Sanctuary is a treatment and organizational change model that integrates

trauma theory with the creation of therapeutic communities which provide safety for both clients and the staff who work with them.

A perspective that asks: “what’s happened to you?” rather than “what’s wrong with you?” when organizing goals and assessing strengths and challenges

A perspective that asks: “what’s happened to you?” rather than “what’s wrong with you?” when organizing goals and assessing strengths and challenges

A belief that adversity is an inherent part of human life, and that many of the behaviors that lead clients to care are directly related to those experiences – and that people and groups of people can heal from those experiences

A belief that adversity is an inherent part of human life, and that many of the behaviors that lead clients to care are directly related to those experiences – and that people and groups of people can heal from those experiences

BASIC BELIEFS OF THE SANCTUARY MODEL

Nonviolence

Emotional Intelligence

Social Learning

Open Communication

Social Responsibility

Democracy

Growth & Change

THE SEVEN COMMITMENTS

S.E.L.F.

Safety

Emotions

Loss

Future

Traumatization occurs when both internal and external resources are inadequate to

cope with external threat.

Van der Kolk, 1989

A collaborative effort of Kaiser Permanente and The Centers for Disease Control

Vincent J. Felitti, M.D.Robert F. Anda, M.D.

THE RELATIONSHIP OF ADVERSE CHILDHOOD EXPERIENCES TO

ADULT HEALTH STATUS

CHILDHOOD ADVERSITY BY CATEGORIES(18 years or younger)

Abuse Household

Psychological (by parents) Substance Abuse

Physical (by parents) Mental Illness

Sexual (anyone) Parental separation/divorce

Emotional neglect Mother Treated Violently

Physical neglect Imprisoned Household Member

PERCENT OF PARTICIPANTS EXPOSED TO AT LEAST ONE ADVERSE CHILDHOOD EXPERIENCE

67%

33%Those reporting no exposure

Those reporting exposure to at least one ACE

ACE SCORE

These numbers may suggest that 2/3 of the

U.S. population may have been exposed to at least one adverse

childhood experience!These numbers may

suggest that 2/3 of the people who come to us for services may

have been exposed to at least one adverse

childhood experience!

ACE StudyStrong, graded relation to childhood adversity in

childhood:

Smoking Attempted suicideCOPD RevictimizationHeart Disease Teen pregnancyDiabetes FracturesObesity PromiscuityHepatitis Sexually transmitted

diseaseAlcoholism Poor job performanceOther substance abuse Poor self-rated healthDepression Violent relationships

ACES & INTERPERSONAL VIOLENCE

As the number of ACE increases the number of co-occurring or “co-morbid” conditions increases.

As the number of violent experiences increases, the risks of victimization among women and perpetration by men also increase by about 60% to 70%.

As the ACEs score increases the likelihood of revictimization – of being raped, of being assaulted - increases steadily

DiseaseDisability Social Problems

High Risk Behaviors

Social, Emotional, Cognitive Problems

Childhood Adversity

Out of 350 people working in social services

Psychological abuse (Parents) 37%Physical abuse (parents) 29%Sexually abused 25%Emotional neglect 35%Physical neglect 12%Substance abuser in household 40%Separated from one/both parents 41%Witnessed DV 21%Imprisoned household member 10%

It’s Not Just the Clients

Most neural network

development occurs after

birth

Genes just supply basic

blueprint

TRAUMA ALTERS THE WAY THE BRAIN WORKS

So by age 10 a child’s value

system is already

embedded in the child’s brain

Bottom line: THE

ENVIRONMENT PHYSICALLY

CHANGES THE BRAIN

Chronic Stress Crises

Chronic Hyperarousal

TRAUMA ALTERS THE WAY THE BRAIN WORKS

Hypersensitivity to even

minor threatExtremist thinking

Respond to many things as threat to

life – aggression

and impulse control

Attention to threat while ignoring less threatening,

but important

information

TRAUMA ALTERS THE WAY THE BRAIN WORKS

Interferes with normal emotional &

cognitive development

Emotional states too intense to handle

Reinforced by helplessness and need for control

TRAUMA ALTERS THE WAY THE BRAIN WORKS

substance abuse violence self-

mutilation risk taking Impaired parenting

POOR EMOTIONAL MANAGEMENT LEADS TO:

DISSOCIATIONDisruption in the normal integration of thoughts, feelings, memories, identityNormal life process – autopilot; Very efficient – let’s us do two things at once

Important response to trauma

State of shock – buffers and protects central nervous system

Prevents death from overwhelming feelings

Amnesia

Prolonged “shock” : Emotional numbing

In extreme cases beginning in childhood – splits in personality

DissociationAlexithymia – No words for feelings

Haunted by the past:

flashbacks, nightmares,

body memories

Traumatic Reenactment - Revictimization

TRAUMA ALTERS THE WAY THE BRAIN WORKS

SO WHAT DO WE DO????

We change the question from:

•“What’s Wrong With You?” to “What’s Happened To You?”

We create a trauma-

sensitive culture

•recognizing symptoms as survival skills

We give them a different

experience

•Create a compassionate, trauma informed environment

THE SANCTUARY MODEL TOOLKITCommunity meetings

Psychoeducation Groups

Red Flag Meetings

Safety Plans

Self Care Plans

Team Meetings

Treatment Planning Conference

ProQol Scale

Thank You!!!