Trauma can occur from various events, resulting from single incident to complex post traumatic

stress experiences. The person will be gripped in the fear if frightening sensations are not given
to him/her through the body. In context to it, I have created this document to reflect traumatic
responsive practice conducted on a victim of child abuse and sexual assault, Alex. He got
separated from his home when he was six or seven years old. So, this critical reflection covers
phase 1 approaches applied to treat his situation and analysis of my strengths and weaknesses
being a practitioner throughout the session.
How relationship with Alex was built and how were I was person centred?
When a person is victim of child abuse or sexual assault, it shuts down the feelings of an
individual and they always try to push away the memories of pain. They have tendency of stop
believing and trusting on the relationships around them that aims of protecting them. So, for
supporting Alex, I tried to develop a safe environment for him so that he gets comfortable. When
he entered the room, I made sure that his seating is at appropriate distance from mine. Harms
( 2015) believes that therapist must always focus on truth-telling approach as it reflects
cooperative nature of the work. When a client enters in a therapy relationship, he/she has faced
severe damage towards the capacity of appropriate trust, so it is important for practitioner to
build up a trust level before focusing on the problems of client. To gain trust of Alex, I assured
him that whatever he will share, I will be non-judgemental and respect his confidentiality. His
story will stay between both of us and he can share whatever he wants to tell me. This led a
foundation of trust between Alex and me.
Grantham (1972) also emphasises on attention to be drawn towards boundaries of the therapeutic
relationship as it provides best protection against unmanageable transference reactions. I built a
healthy relationship with Alex by not asking any extra questions regarding his personal life.
Before jumping on the traumatic experience of Alex, I made him practice certain exercises so
that he gets comfortable in the surrounding environment. I showed empathetic understanding
about his traumatic journey and recognised the emotional experience without being emotionally
involved in the situation. I made sure that to bring some positive change and self regulation of
emotions in Alex, there is a need to establish a relationship. I believe that TIC is strongly based
on shared power between client and practitioner and this relationship promotes healing. So, to
develop our client-practitioner bond, I narrated some personal instances to Alex. For example, I
told him that I do breathing exercise when I am anxious. The exercise calms me down and
reduces the heart rate. I think this connection is important to be felt by the client and that is how
it gives the client an emotional corrective experience. (Levenson, 2017) states that individuals
who have faced childhood abuse are survivors who feel powerless because choice and
predictability is absent in their daily life activities, so it is paramount to create a healthy
relationship with them so that they can trust on you.
Using Polyvagal theory to implement social engagement skills.
Porges proposed polyvagal theory which states that there are two branches of the vagus that are
associated with different behavioural strategies and work together with sympathetic nervous
system (PORGES, 2003). The new branch is involved in regulating heart and lungs during social
interactions. When we say social engagement skills, it involves talking, self soothing, co-
regulating, calming to inhibit sympathetic-adrenal influence. In case of children who went
through complex trauma have limited capacity of accessing the circuitry. So, for them
interventions such as breathing, and body movement exercises are recommended.
Therefore, on applying the Polyvagal concept, I recommended Alex to do inhaling and exhaling
exercise. After doing that he felt much relaxed and comfortable. In order to increase the capacity
for relational management, I created a safe and stabilised environment for ANS responses
(PORGES, 2003). I ensured that there is very little disturbance in the room, placed rug on the
non-carpeted floor, adjusted room heating and cooling to promote safety and so that Alex can
respond well to the exercises. I created a social engagement system for Alex by listening to his
story and acknowledging his pain. For children who have little use of social engagement are
likely to have little tone in the middle ear muscles that work for filtering the background noise
and draw focus on human voice (Polyvagal Theory, 2011).
To facilitate therapeutic interventions, it is necessary to develop an attachment relationship with
client, especially when the victim is young adult. This is because when the caregivers are
familiar it is effective for safety neuroception of the child and for promoting appropriate social
behaviour. That is why consistency of caretaker for children is crucial in promoting safety and
social engagement (Polyvagal Theory, 2011). For establishing the social engagement skills, I
empowered Alex for coming here for the session and sharing his story. This is a very courageous
job as it was very hard for him to talk about his sexual assault. When a person is in trauma, it
affects its ability to evaluate whether the environment is safe or the practitioner is trustworthy
etc. So, I developed a trust level by acknowledging Alex’s pain and stating that it is very hard to
come up and share personal things with another person. Further, I recommended him to massage
his body so that he calms down after having heavy discussion about his trauma. When we
massage our body, it stimulates vagus and activates oxytocin in the body which inhibits release
of stress chemicals (Polyvagal Theory, 2011). Doing so actually worked for Alex as after
discussing about his child abuse story, he got sad and depressed. However, after doing the
exercise he felt good.
How was the client resourced?
Alex is a survivor of child abuse and sexual assault who is suffering from post-traumatic stress
disorder. The client was resourced by developing new coping strategies such as body awareness
technique. I asked Alex to choose a color and then feel it on his body. When he replied he feels
red color across his body, then I asked him to tell the size of that feel, whether it is of pin size or
large as mountain. Such type of exercises creates body awareness of the victim on which he is
feeling the pain. ( Schuldt, 2020) believes that grounding techniques are useful in managing the
traumatic experiences and memories of the client.
To make Alex feel his senses, I planned a touching and sensing activity for him. I asked Alex to
choose any two surfaces and then feel the texture and temperature of it. He touched cushion of
chair and a table. On touching both he replied that table is rough and cushion of chair is smooth,
but he liked touching table more as it is cool. This shows his sense of touching towards different
materials. A researcher states for a trauma victim in order to begin healing, it is required to
support the development of skills and increase safety of feelings (Grounding techniques, 2020).
This is a key to agency and resilience approach for treating a trauma victim. When practitioner
designs grounding activities, it increases awareness of trauma responses, assist in developing
therapeutic bonds that can be covered in safety plans and offer validation. These activities aim at
bringing back the victim to reality during traumatic flashback (Grounding techniques, 2020).
When the focus is on current surroundings, the victim becomes capable of getting aware of their
safer reality and start feeling calmer. To draw upon agency and resilience of Alex, I conducted
breathing and mindfulness activities to make him comfortable to talk about his trauma. When a
practitioner creates a space for positive mind or body experiences, it leads to expanding the
window of tolerance which helps victim in coping up the trauma (Connecting the brain, 2022).
As per Malchiodi, current practitioners focus on this tolerance window expansion strategy and
she observed that there is lack of self compassion, engagement, and curiosity towards positive
aspects of life, in the resilience strategy (Connecting the brain, 2022). She recommends that
engaging victim in pleasurable and positive experiences can be an excellent key to treat trauma
(Connecting the brain, 2022).
How did I focused on being strengths based?
Adopting a strengths-based approach in TIC means challenging and exploring your assumptions
about people such as why, how and when they are struggling. A problem focus approach may
work in some areas, but it can make people feel stuck in a loop. This involves finding out and
communicating what is working well as this generates a hope and self-efficacy in the person.
When a person is in trauma, they experience fluctuations in their emotions and beliefs, can make
application of hopeful approach quite difficult. To apply strengths-based approach, it is crucial to
possess skills and look for areas for strengthening self-efficacy of the victim in order to recover
the trauma.
I followed the approach by appreciating Alex for coming up and sharing such a harsh and
sensitive story with me. I made him realise that this is not easy to do and he should be proud of
himself for trusting me and sharing personal story. During the session, I tried to look for his
strengths such as how he communicates his experiences, which color he likes, how he can feel
the things etc. I believe the approach is effective for healing Alex’s trauma as the focus is on
what is working, rather what’s not. In this approach, I look for the efforts of Alex to persevere
despite of challenges of life. This will help him in finding his strengths and ability to cope up
with the stress.
Stoerkel (2023) highlights in his research that strength-based approach depends on the ability of
client to process their thoughts and emotions. The environment supports open communication,
motivating clients to determine their value, strengths and capacities. When they are supported
under this approach, they see themselves at their best and the value they tend to bring to
themselves (Stoerkel, 2023). However, this approach not only examines the person, but
environment too. This means the highly dependence of this approach is on how the system is
being set up, power imbalances between system and the people who are supposed to deliver the
service. While following the approach, I identified certain constraints that were holding Alex
back, and the constraint was personal (Stoerkel, 2023). He was uncomfortable initially to discuss
the trauma as he was ashamed. In the back of his mind he thought there is no one who can
understand his situation. So, to support him, I made him comfortable and gained his trust that the
talk will stay confidential between him and me. I ensured that I am using respectful language
while communicating with him and encouraged him to share his emotions, feelings and
experiences.
What is recommended for further sessions and for phase 2?
Phase 2 of TIC is more about making sense and meaning of the trauma. In this phase client may
explore the trauma experience by desensitising negative feelings linked with their memories.
For Alex, I would recommend compassion focused therapy for agency and resilience approach.
The purpose of this therapy is to help the client in promoting mental and emotional healing via
motivating him to be compassionate toward themselves (Simos, 2022). The output of the therapy
leads to improvement in mental and emotional health. In this strategy, Alex can be engaged in
body movement activities that involves mind, such as mindfulness, awareness, movement, yoga,
posture, breathing etc. The practitioner must aim of cultivating compassionate qualities among
the clients, such as allowing them to choose key compassionate qualities for creating wisdom,
developing self and concept of tricky brain. With Alex, openness needs to be practiced and he
should be encouraged to imagine compassionate self (Simos, 2022). The strategy is appropriate
for clients suffering from child abuse because they start hating themselves when being abused.
Also, Alex feels that changing foster home did not helped him to escape from the problem, so he
developed a feeling that there is some fault in him that is why he is being abused. When the
compassion focused therapy will be conducted, it will help Alex to stay at the comfort side and
he will feel strong enough to talk about his traumatic experience (Germer, 2015). The openness
will support communication and he will start getting aware about his trauma.
Secondly, I would recommend Somatic therapy as it is effective for childhood trauma. The aims
to recover self-regulation by letting go of stored up survival energy (Payne, 2015). Following a
traumatic occurrence, somatic therapy releases mental and physical stress that has built up inside
the autonomic nervous system. Techniques used in somatic therapy help traumatised people
regain their vitality, calmness, and sense of wholeness by relieving the body's natural healing
processes of traumatic stress (Payne, 2015). I have recommended this strategy for Alex as it will
assist him in identifying how the aftereffects of trauma are hurting his capacity to experience joy,
satisfaction, or physical pleasure. He will be able to complete processing of traumatic events
through SE therapy and get the knowledge and abilities required to encourage healthy self-
regulation (Payne, 2015). He will have the innate capacity to manage stress and bounce back
from traumatic experiences. Also, it will allow him to release the negative energy with the aid of
a SE-trained mental health counsellor, which will allow him to realise that the threat has passed.
As per the strategy, client's level of comfort at each stage of the process, though, determines how
quickly things move along (Payne, 2015). Once the client has developed the resilience to fully
connect and release the trauma energy, the gentle investigation will continue.
What I did well and what did I determine as needing improvement?
 The crucial role of trauma-informed caregiver is to help the clients in discussing their painful
memories and reducing the anxiety to a tolerable state, and level up their capacity for modulating
their emotions and behaviour. For Alex to enjoy healthy interpersonal interactions, I worked to
establish a safe atmosphere that promotes trust, autonomy, collaboration, and empowerment
across treatment modalities (Grafa, 2020). I recognised the prevalence of trauma, the impact that
violence and victimisation can have on psychosocial growth and lifetime coping mechanisms,
and the need of emphasising client strengths rather than pathology. I also focused on developing
healthy abilities rather than just resolving it. Being ethical practitioner, I aim of providing
services in a way that acknowledges the emotional susceptibility of trauma survivors, and most
importantly, avoided unintentionally recreating abusive interaction patterns in the relationship-
helping process throughout the session (Grafa, 2020). During the discussion, I tried to create a
safe environment for Alex and worked towards delivering respect, openness, and care. I learned
from this experience that the neuroception of safety was maintained by moving through the
waiting area in a state of mindful, warm connection with Alex.
However, I have determined certain areas where improvement is required being a trauma-
informed care practitioner. Through the experience I learned that I lack in knowledge about how
to design resilience strategy for child in trauma. (Treisman, 2017) highlights that childhood
trauma is recurring and overlapping which is shaped due to multiple factors. Therefore, there is
need to improve my knowledge on coping strategies for childhood trauma. Further, at 0:58
minutes of the recording, I asked Alex about positioning of chair that shall I move chair behind
or not. I think I could have asked him empathetically rather than being blunt. Again, when Alex
said that his feeling of red color on the body is of room size at 3:30 minutes, I could have
questioned him more about it. For example, I could have asked him why he is feeling that
problem, which specific body part he is feeling it etc., rather than jumping to the next question. I
need to improve my collaboration skills so that the client feels openness through the session.
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