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VSI ©: An Exploratory Model for Complex Trauma Specific Treatment

  The effects of trauma are substantial, impacting a person’s physical, mental, emotional, spiritual, social and economic well-being. Chronic physical and/or sexual abuse has been shown to play complex roles in the development of mental health symptoms, substance abuse, in addition to a diverse range of physical health manifestations. Trauma results from a psychological injury as opposed to manifesting as a mental illness. The paradigm shift from viewing trauma as an illness to that of an injury remains recent.

  “Because the features of varying levels of traumatization possess similar features, the recovery process also must follow a common pathway which includes establishing safety, affect regulation, reconstructing the trauma story, processing grief and loss related issues, and restoring the connection between survivors and their community by processing the impact of the elements of the trauma on the survivor’s life in the here and now [Bloom, 1997; Herman, 1992; Gray, 2003]. Identification, acknowledgement of the injury[ies] and permission to grieve what has become recognized as a multitude of layers of ambiguous issues related to grief and loss associated with betrayal validates the experience of the individual[s] harned by the trauma[s] and assists in the process of recovery and revival of the soul unto the self.”  

  Trauma specific services are designed to address the associated behavioral, intrapsychic and interpersonal consequences of exposure to sexual, physical and prolonged abuses. Unfortunately, many of these intervention tools do not move beyond the survivor stage which, while it permits the individual to develop some degree of resiliency, does not empower the individual to practice and incorporate new skills into every day quality of life activities.

  VSI © is a multi-dimensional, client friendly, flexible model of working with individual who present with trauma through a relational narrative approach that focuses on collaborating with the individual to build on existing inherent resiliency or developing resilience as a means of assimilating victimization and survival as well as promoting adaptation to a normalized lifestyle. VSI © utilizes a strengths based,  three stage approach that begins with the victim stance, moves into the survivor phase and to the final stage of integration. This three stage model of Victim, Survivor and Integration incorporates the stages of change and healing in its application. When entering treatment, consumers will be typically stuck in the Victim Stance where one operates with feelings, thoughts and behaviors that are disempowering, unsafe and unhealthy. During this first stage the therapist and consumer assess through initial assessment as well as utilizing subsequent assessment instruments which focus on the specific traumatic stress characteristics pertaining to the identified consumer, develop a collaborative treatment plan based on challenging negative core beliefs using the principles of Cognitive Behavioral Therapy in conjunction with art, bibliotherapy, self awareness and challenging faulty assumptions via the establishment of a safe and trusting authentic relationship. Family and partner involvement is encouraged, supported and remains appropriate in most circumstances where safety is not at risk for being compromised.

  The second stage of treatment shows a shift from Victim Stance to Survivor whereby the individual takes actions that promote safety and health. This stage focuses on empowerment and utilizes specific tools identified by the consumer and the therapist from which to utilize in order to self regulate affect, stress, distress and reactivity through a higher evolution into self awareness. These tools remain to be age appropriate [emotional age, not chronological age] designed to meet the consumer at his/her level of functioning whether child, adolescent or adult, through the means of art, Play Therapy, Therapeutic Play, Sand Tray Therapy, Journaliing/Bibliotherapy which contribute to the creation of a self narrative; essential to the healing process by the means of redefining one’s self through loving compassionate approaches as opposed to distorted self loathing shame based belief systems. As such, ongoing understanding respective to the function and developmental placement of defense strategies remains to be important.

  Integration, the third stage remains to be a stage of maintenance: maintaining the gains and changes. This stage emphasizes the integration of resilience, empowerment, problem solving and effecting healthy relationships with self and others.

  Safe Pathways Counseling Inc. provides individual, family, couples and group counseling services in an outpatient capacity, In addition, we contract with organizations to provide trauma specific and trauma informed directed workshops for professionals and members of the community at large respective to many aspects of trauma which includes, Post Traumatic Stress Disorder [PTSD], Complex PTSD, Dissociative Disorders, and Disorders of Extreme Stress Not Otherwise Specified [DESNOS] resulting from  child/adult sexual abuse, assault, neglect and /or exposure to violence or abuse [includes combat veterans and families], LGBTQI issues, Anxiety Disorders, Mood Disorders, Grief and Loss [Specific and Ambiguous], Medical Trauma [includes coping with debilitating disease, illness or life changing conditions], Co-Occurring Disorders, Relationship Instability, Substance Abuse and Addiction utilizing Harm Reduction Theory as well as Traditional theory focused on abstaining from use]Process Addictions [Includes Eating Disorders, Compulsive Gambling, Self Mutilation, Body Dysmorphic Disorders, related in shame based cognitive distortions], and Risky Sexual Behaviors and Sexual Disorders.

  Safe Pathways Counseling Inc. offers specialized treatment and assessment for varying degrees of Offenders. Because we specialize in trauma, it remains to be understood that “hurt people often hurt people.” Although this is understood, it is not justified. Our focus remains to be that of safe and ethical treatment for all whom we serve. Our specialized offender assessors and practitioners schedule offenders by appointment only and when other consumers are not present or at risk for harm.

  Safe Pathways Counseling Inc. has devised a highly specialized Trauma Assessment Battery consisting of self report measures, unstructured instruments, semi structured instruments and structured clinical instruments specifically oriented to diagnose or disprove Post Traumatic Stress Disorder, Complex Post Traumatic Stress Disorder, Dissociative Disorders and Disorders of Extreme Stress Not Otherwise Specified. This service remains to be both forensic in nature and unique in origin and has been instrumental in diagnosing or disproving injury pertaining to Civil litigation which focuses on gross negligence, malpractice, legitimacy of injury and liability cases. The highly specialized comprehensive report reflects an analysis of the history, raw data, current evidence based research on traumatic stress, diagnosis and prognosis. This service remains limited to the expertise and capabilities of Dr. Marie C. Gray and said service has not been or is not to be replicated by any other individual currently or formerly associated with this practice based on the ability to understand, interpret and integrate the history, current status and theory into a valid instrument. This service is not covered by insurance.

  Each of our Practitioners remains classified and qualified as “Expert Witnesses” within the court system as well as credentialed as Expert Witnesses through National Center for Crisis Management as part of our parent/child reunification service, and child custody family therapeutic intervention services. These services are not to be confused with standard and traditional custody evaluations which themselves manifest as a short forensic non therapeutic assessment. This service remains unique in that it seeks to assist the parties in healing from injuries pertaining to toxic relationships particularly with specific focus on assisting the parents in developing appropriate communication and healthy interaction for the benefit of the children involved. This service remains to be highly specialized in that the complexities of the individual, couples, relationship vulnerabilities as well as overall theoretical orientation pertaining to family dynamics results in an intense therapeutic process as opposed to a non involved forensic intervention. Although these services will require testimony either through attendance or phone conference and will require written treatment interpretation narratives for the involved parties and the courts, which remain to be similar to a custody “evaluation” the therapeutic aspect of this service remains to be the core focus in healing and recovery for involved parties.  Court Testimony and written narratives are not covered by insurance.

  As with any of our Court-Ordered cases or cases which involve litigation, Safe Pathways Counseling Inc. and it's individual clinicians are to be “held harmless” by any outside litigation pertaining to any potential disagreement within the clinical components and/or information as well as recommendations herewith pertaining to the resulting report, testimony and/or treatment. Additionally, Consumers remain free to obtain a second opinion if in disagreement with the clinical rationale of the report, testimony and treatment without prejudice. Safe Pathways Counseling Inc. reserves the right to refuse to engage in any Court ordered treatment as well as any non-judicially oriented treatment at the discretion of the identified clinician and overall practice. At such time the consumer and/or court [if appropriate] will be respectfully notified and subsequent appropriate referrals to other providers will be suggested.

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