Continuing our series from the TIHCER Special Section on TIC in The Permanente Journal

Continuing our series from the TIHCER Special Section on TIC in The Permanente Journal – we have two great presentations this month!

Read the entire special section on Innovations in Trauma-Informed Health Care: https://www.thepermanentejournal.org/collection-trauma-informed-healthcare

Presentation #1 Time to Move Forward: Resilience and Trauma-Informed Care

Building on advances in neuroscience and resilience research, the authors advocate for a shift from the pathology focused biomedical model to a focus on resilience and trauma informed care.  Programs that utilize attention management skills, mindfulness, and knowledge about the autonomic nervous system are relevant to clinical settings.

Brigid McCaw, MD, MS, MPH, FACP led the implementation of a comprehensive approach for improving screening, identification, and services for intimate partner violence (IPV) at Kaiser Permanente from 2001-2019. In addition to clinical practice, her career has focused on health effects of IPV; improving the health systems response to family violence; ACE’s prevention, screening and response; and trauma and resiliency informed care. She is a clinical advisor to the California ACES Aware Initiative. She completed her MD, MS, MPH at UC Berkeley and UCSF, and internal medicine residency at UC Davis.

Laurie Leitch, PhD has been a practicing psychotherapist, clinical trainer, consultant, social entrepreneur and researcher for over 25 years. She is Director of Threshold GlobalWorks, dedicated to cultivating the social dimension of resilience in individuals and within communities, enterprises and systems. Committed to promoting workplaces and communities in which principled behavior and collaboration are the norm, Leitch’s organization, Threshold GlobalWorks, has developed a neuroscience-based curriculum, Social Resilience Model (SRM) for building social resilience at the individual and system’s level. The curriculum has been used in a wide range of organizations including military, medical, educational, criminal-legal and corporate settings nationally and internationally to promote organization resilience and pro-social, generative relationships among individuals and across disciplines. The practical SRM skills are used to improve health literacy and cognitive, emotional, social, and physical health as well as to foster dignity and pro-social behaviors. SRM’s model is also being used in communities which have lived with systemic racism to build on community strengths and network diverse groups to enhance safety, advocacy efforts and inherent resilience. Dr. Leitch developed the survey tool PACES (Positive and Adverse Childhood Experiences Survey) as an alternative to the Adverse Childhood Experiences Survey (ACES) and emphasizes the importance of collecting resilience indicators in both research and social service agencies.

Presentation #2 Respecting Body-Size Diversity in Patients: A Trauma-Informed Approach for Clinicians

Weight bias is entrenched in health care settings, influencing clinicians’ attitudes and behaviors, the medical community’s perception of the underlying factors informing body size, and, ultimately, patients’ experiences with care. TIC is an opportunity to understand our patients better, empathize with their experiences, and provide more comprehensive care. Ultimately, it will empower clinicians with an approach to working with patients of diverse body sizes in a manner that is affirming and therapeutic, guiding patients in embracing and honoring their bodies

Alison Mosier-Mills, MD is a first-year resident in Psychiatry at New York Presbyterian-Weill Cornell. She received her MD from Harvard Medical School and her BA from Yale University. She is interested in trauma-informed care, medical education, and medical humanities.

Sadie Elisseou, MD (she/her) is a primary care physician in the Boston VA healthcare system, a Clinical Instructor of Medicine at Harvard Medical School and Adjunct Instructor of Medicine at Boston University School of Medicine, and an internationally recognized expert in the field of trauma-informed care (TIC). Dr. Elisseou's award-winning curriculum is now taught at medical schools across the U.S. She has published novel frameworks for trauma-informed medical education, trauma-informed approaches to burnout, and trauma-informed leadership. Dr. Elisseou is the co-founder of the National Veterans’ Health Administration TIC Collaborative and a member of the Harvard Medical School TIC-informed resilience.