Developing Trauma Informed Services for Psychosis A Multidisciplinary Journey Towards Healing

Introduction

Kristina Muenzenmaier, Mara Conan, Gillian Stephens Langdon, Toshiko Kobayashi, and Andres R. Schneeberger

Section 1: Foundations of a Trauma Informed Approach in a Psychiatric Facility

1. The Relationship between Trauma and Psychosis: Historical Background and Theoretical Issues

Kristina Muenzenmaier and Andres R. Schneeberger

2. Life Experience Behind & Beside Symptoms

Mary Auslander

3. Discovering Trauma Histories in People with Psychosis Leads to Political Action

Kristina Muenzenmaier, Andres R. Schneeberger and Mary Auslander

4. Implementing Hospital-wide Trauma Assessments

Kristina Muenzenmaier, Mara Conan, Gillian Stephens Langdon, Toshiko Kobayashi and Joseph Battaglia

5. Formation and Development of the Trauma Committee

Kristina Muenzenmaier, Gillian Stephens Langdon, Mara Conan, Toshiko Kobayashi and Joseph Battaglia

6. Widening the Circle of Care: Trauma Programme for Staff

Kristina Muenzenmaier, Toshiko Kobayashi and Joseph Battaglia

Section 2: Trauma Informed Interventions: From Fragmentation to Integration

7. Exploring a Group Therapy Approach for Healing from Complex Trauma

Mara Conan, Kristina Muenzenmaier, Gillian Stephens Langdon and Toshiko Kobayashi

8. Implementing a Trauma Informed Approach on an Inpatient Unit

Kristina Muenzenmaier, Gillian Stephens Langdon, Toshiko Kobayashi, Mara Conan and Joseph Battaglia

9. Trauma-Informed Care in Outpatient Clinics

Mara Conan, Gillian Stephens Langdon, Toshiko Kobayashi and Kristina Muenzenmaier

10. Family Therapy Model for Treating Trauma in People with Serious Mental Illness

Madeline Seifter Abrams and Kristina Muenzenmaier

11. Towards an LGBTQI+ Affirmative and Trauma Informed Approach in People with Psychosis

Andres R. Schneeberger

Section 3: Trauma Informed Interventions: Collaboration with Creative Arts Therapies Opens Up New Doors in Trauma Treatment

12. Music Therapy: Exploring a Structured Trauma Informed Group Therapy Model

Gillian Stephens Langdon, Gina Kijek and Stacie Aamon Yeldell

13. Interweaving Words and Music in Music-Verbal Therapy Trauma Groups

Gillian Stephens Langdon

14. Developing Structured Art Therapy Groups to Treat Complex Trauma

Toshiko Kobayashi and Kimberly Michaud

15. Folding and Unfolding: Expanding Trauma Focused Art Therapy

Toshiko Kobayashi, Amara Clark, Eunhong Park, Ping-Rong Chen and Kamila Agi-Mejias

16. Trauma Informed Dance/Movement Therapy: Embodied Moving and Dancing

Kelly Long

17. Conclusion

Kristina Muenzenmaier, Mara Conan, Gillian Stephens Langdon, Toshiko Kobayashi and Andres R. Schneeberger

Biography

Kristina Muenzenmaier is associate clinical professor of psychiatry and behavioral sciences at the Albert Einstein College of Medicine, USA. Her clinical and research interests focus on public psychiatry and childhood trauma in people with serious mental illness and psychosis.

Mara Conan was asistant professor of psychiatry and behavioral sciences at the Albert Einstein College of Medicine, USA (2003-2014). She has worked for over 30 years as a psychologist in public psychiatry with individuals who were diagnosed with psychotic disorders.

Gillian Stephens Langdon is an adjunct professor and internship supervisor in the Music Therapy Department at New York University, USA. A pioneer of music therapy, she has worked for over 40 years with people experiencing psychosis and trauma.

Toshiko Kobayashi is an onsite supervisor and guest speaker at New York University. She worked for many years as an art therapist both in the United States and internationally. She developed Expressive Origami Therapy® and is president of the Origami Therapy Association. Currently, her focuses are intergenerational trauma and self-care.

Andres R. Schneeberger is an associate clinical professor at the University of California San Diego, Department of Psychiatry, USA. His main clinical and research interest focus is on mental health care delivery, measurement-based care, aggression, coercion and complex traumatisation in minority populations and people with serious mental illness.

'Admission to a psychiatric unit is a terrifying and demoralizing experience for people who feel that they are already standing on a precipice from which there is no return. That is why this is such an important book. The kind of facility being described here holds the possibility of helping people whose lives have been desperately hurt not to jump off that precipice but instead to make life-affirming decisions focused on healing and recovery. For me, this book is about passing the baton to a new generation of people who care about some of the most vulnerable in our culture.'

Sandra L. Bloom, M.D., author, Creating Sanctuary: Toward the Evolution of Sane Societies, www.creatingpresence.net

'What an important and timely book this is – the first to describe a comprehensive attempt to institute a trauma-informed approach to psychosis on an inpatient unit. It is fascinating to read about the multi-year journey of dedicated clinicians and researchers – and their patients – confronting and overcoming obstacles and learning much personally and professionally in the process – including the crucial importance of the creative art therapies to healing from trauma and psychosis. This pioneering book will provide a blueprint worth its weight in gold for anyone hoping to develop a trauma-informed psychosis unit. May this success story encourage many to try!'

Andrew Moskowitz, Ph.D., lead editor of Psychosis, Trauma and Dissociation (Wiley, 2008, 2019) and Associate Professor of Psychology at the George Washington University in Washington, DC

'Workers in public psychiatric settings can find it hard to keep their eyes on the prize of humane, healing treatment, plowed under as they are by funding concerns and ever-increasing regulations and documentation. In this inspiring book, a multi-disciplinary team documents their efforts over the years to transform psychiatric care through a deep understanding of the effects of trauma in the lives of people with serious mental illness. Chapters detail from multiple perspectives how this attention to trauma results in a safer, healthier environment for staff, who can in turn provide compassion and healing for the people in their care. Interestingly, creative arts therapies are a crucial part of the solution, and all staff are considered. The psychiatric system is much in need of this hopeful message, and detailed map of the way forward.'

Julie Kipp, PhD., LCSW, President of the Executive Committee of the International Society for Psychological and Social Approaches to Psychosis (ISPS)

'This is a significant book that supports the connection between trauma and psychosis while illuminating the healing process that is possible within a multicultural, multidisciplinary team approach. Of note is the authors’ elucidation of the effectiveness of creative arts therapies in transforming feelings of isolation into an experience of belonging.'

Diane Austin, D.A., LCAT, author of "The Wounded Healer" in Music, Music Therapy and Trauma: International Perspectives by Julie P. Sutton (2002)

'I am so excited that you all wrote about psychosis and healing! What a legend team. I haven’t stopped talking about you and the committee’s work and support.'

Rebecca Zarate, PhD., MT-BC, LCAT, author of Music Psychotherapy and Anxiety: Social, Community, and Clinical Contexts (2022) and former trainee and member of the Trauma Committee

'In this fascinating book, the authors share the treasure of their extensive experience in developing trauma-informed services for patients diagnosed with psychosis. They provide the reader with a wealth of hands-on experiences, ranging from the gradual establishment of trauma-informed structures and changes in institutional policy to innovative therapeutic approaches for different settings. One of the book's greatest strengths is the strong focus on service-users’ perspectives. It consistently includes the viewpoint of survivors learning from their experiences in a system that has ignored their needs for far too long. A book full of valuable advice that will literally be a textbook for a new generation of trauma-informed services.'

Ingo Schäfer, MD, MPH, Associate Professor of Psychiatry at the University of Hamburg, Germany