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Cumulative Trauma and the Violently Injured Patient

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October 15, 2014
1:30 pm - 4:30 pm

English Foundation Building


Training Details:

Interpersonal violence is a major public health problem in the United States and hospitals stand on the front line of it. Trauma Centers and emergency departments are in the unique position of treating the violently injured patient at a crucial point where a life may stand in the balance. The relationship between a victim of violence and the hospital often typifies the “revolving door” phenomenon as, for many individuals receiving care there, violent injury is not a one-time event. Being the victim of violence also significantly increases the likelihood of being a perpetrator of violence since the “code of the streets” may lead violently injured youth to believe that retaliating against their perpetrator is necessary to avoid re-victimization.

Injury prevention activities are a defining characteristic of trauma centers today. Advances in trauma care increase the likelihood that a patient will survive a violent injury but do nothing to reduce the chances that they will be reinjured after leaving the hospital. In addition to the overtly physical consequences of violent injury, many individuals experience psychological sequelae, which persist long after their physical wounds have been treated. The mental health consequences of violent injury may also be compounded by the effects of traumatic experiences earlier in life.

The Eskenazi Health trauma team, like other hospital-based violence intervention programs (HVIPs) embraces a public health approach to violence prevention and believes not only that violence is preventable but that empirical evidence suggests that violent injury offers a “teachable moment” and unique opportunities to break the cycle of violence. Prescription for Hope is the interpersonal violence intervention and prevention umbrella program for Eskenazi Health and the Smith Level 1 Shock Trauma Center. This trauma informed, culturally competent program enhances the “teachable moment” by intervening at the hospital bedside when a person is most open to addressing the risk factors associated with intentional injury and lifestyle choices which contribute to violence and crime.

Program Objectives:

  1. Understand the “revolving door” phenomenon of the emergency department and shock trauma center involved with violent injury patients.
  2. Describe the “teachable moment and cultural competence” for working with youth violence.
  3. Know the definition of trauma, violent injury and youth violence.
  4. Identify the four fundamental domains of disruption in a traumatized person’s life.
  5. Describe the cycle of violence.
  6. Reach a basic understanding of the psychobiology of trauma and adversity in interpersonal violence.
  7. Assess an individual’s propensity for violence victimization and/or perpetration using risk and protective factors.
  8. Create a safety plan using the principles of trauma informed practice.

Speaker Bio:

Diana Creasser has worked in the field of mental health in clinical, education and administrative roles. She is currently the manager of Prescription for Hope (RxH), the hospital based violence intervention and prevention umbrella program for Eskenazi Health. In this capacity, she works with a team of trauma staff dedicated to injury prevention, especially the intentional injury associated with violence. The Smith Level 1 Shock Trauma Center treats nearly double the amount of trauma patients associated with violent injury in one year compared to national averages of other trauma centers, so special focus is given to intentional injury prevention.

Prescription for Hope is also a leading member of the city’s Youth Violence Reduction Team, an interagency group focused on youth violence from their respective areas of law enforcement, public health, public housing and juvenile justice. Working closely with these agencies, RxH also addresses the youth violent offender with its wraparound services and trauma informed care.

RxH is a member of the National Network of Hospital-based Violence Intervention Programs. In this capacity, Diana Creasser serves on the national policy and research/evaluation committees.   She has co-authored two publications along with other members of the trauma team and national colleagues: “Prescription for Hope(RxH): Trauma Surgeons and Community Aligned to Reduce Injury Recidivism Caused by Violence,” 2012 and “Hospital-based Violence Intervention Programs Save Lives and Money,” 2013.

Cost: $40

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3 CEUs awarded for Social Workers, Marriage & Family Therapists, and Licensed Mental Health Counselors.