Project Reassure: Direct Support Professionals
These materials provide an overview of trauma and resilience and are meant to support the series of online courses available for Direct Support Professionals through the ASERT eLearning platform. To access those courses, click the button below:
Rates of Trauma
Many people in the world have experienced trauma, which means that either yourself, a coworker, people you support, or a friend/family member has likely experienced a traumatic event. Here are some statistics on the rates of trauma:
- 70% of people around the world have been through at least 1 traumatic event.
- 82% of Americans have been through at least 1 traumatic event.
- 30% of people have been through at least 4 traumatic events.
Ways People Experience Trauma
Traumatic events can be experienced by people in different ways. Sometimes, a traumatic event may include more than one of the following types:
Direct
People may go through an event themselves.
Indirect
People experience trauma reactions from seeing someone else go through a traumatic event or listening to others speak about an event.
Work
People may experience traumatic events through their work, like police officers and first responders.
Single Event
This type of trauma only happens once. An example of this is a car accident.
Chronic Event
This type of trauma is a series of events that happens over a period of time. An example of this is the COVID pandemic.
Developmental
This type of trauma happens in childhood. It is also usually chronic. An example of this is having cancer and being treated in the hospital for many months as a child.
Relational
This type of trauma is caused by someone you have a relationship with. An
example of this is being physically abused by a loved one.
Complex
This is when someone has many different types of trauma events. An example
of this is someone whose parents divorced when they were kids, saw a family member get into a bad car accident, and was physically abused by a caregiver.
Causes of Trauma
Trauma can be caused by many different things. Some of the most common experiences that cause trauma are neglect, abuse, sex trafficking, violence in the community or at school, serious accidents, natural disasters, separation from caregivers, and experiences with racism. Almost any event that either causes physical or mental harm or has the potential to cause harm can be considered a traumatic event. 
Impacts of Trauma
Trauma can change the way signals in the brain get sent to the rest of the body. Some effects of trauma can be seen right away, and some effects last for years. Some people may show signs of traumatic stress and others may have few or no signs.
It’s important to realize everyone’s body may react differently, even if they are in the same situation. The brain signals and the way a person is supported by others can change how the body reacts to a traumatic experience. For some people, it may feel like “no big deal.” For other people, it could change the entire rest of their life.
Some signs that a person may have gone through a traumatic event include:
- Signs of depression: They may have a sad or depressed mood, lose interest in favorite activities, feel hopeless, have trouble sleeping or sleep too much, may eat less or a lot more than usual.
- Signs of anxiety: They may have panic attacks, worry, or feel overwhelmed.
- Changes in emotions: They may be more angry or irritable.
- Concentration: They may have a hard time focusing or concentrating or be more forgetful.
- Health problems: They may feel tired, have headaches or stomach aches, or get colds more easily.
Survival Circuit and PTSD
The survival circuit describes how the brain and body respond to threats. The survival circuit is a normal and natural part of being human. The survival circuit helps us to handle any threats that could threaten our safety. There are four main steps in the circuit:
Step 1
Something that we see, hear, smell, taste or touch alerts the brain that there could be danger. The brain reacts immediately, unconsciously, and automatically.
Step 2
The brain sends signals throughout the body to prepare for possible danger. It uses nerve cells that are called the sympathetic nervous system. Just like in step 1, the signals to the body are sent immediately, unconsciously and automatically.
Some examples of how the body reacts to these signals are:
- Heart rate increases.
- Breathing gets faster.
- Body starts to sweat.
- Digestion slows down or stops.
Step 3
Other parts of the brain start to look at what is happening and try to gather more information. The brain compares what is happening to memories and other things we know. The brain tries to determine whether the threat is real or not.
Step 4
If the brain decides the threat is not real of that it can be controlled, signals are sent to the body to begin relaxing. Nerve cells in the parasympathetic nervous system help the body to go back to normal.
Trauma changes the way brain cells connect to each other. In post-traumatic stress disorder (PTSD), the survival circuit becomes overreactive and sensitive to anything that might seem like a threat.
- The parts of the brain involved in fear production become overactive.
- The parts of the brain that control fear, calm us down, and help us learn to overcome anxiety all get suppressed.
- The alarm signals from the brain may stay active, even when the threat is no longer present.
- The survival circuit may activate due to memories or reminders of memories. This includes objects and other things in the environment that do not actually pose a threat.
- When the person comes across these reminders or memories, they may have strong reactions and behaviors that don’t seem to fit the current situation.
Trauma can impact a person’s attention, memory (both short-term and long-term), and how they process information. The brain changes the way a person sees, experiences, and understands the world. These changes in the brain typically result in new behaviors, which are often labeled as symptoms. These symptoms can lead to a variety of problems and diagnoses. Many professionals frequently focus on the symptoms and overlook the person’s trauma experience.
The Four F’s
When your brain detects a threat, your body will react to survive. It does not matter if the threat is real or not. There are four common ways people will react to threats:
Fight: The brain and body prepare to attack.
People who use the fight response may appear angry and aggressive. They are more likely to move towards conflict rather than away from it.
Flight: The brain and body prepare to escape
People who use the flight response may appear anxious and fearful. They may be prone to panic attacks and be avoidant of conflict.
Freeze: The brain and body "freeze" to avoid being seen.
People who use the freeze response may feel stuck or immobile. They may “space out” when they get stressed and can often feel depressed or ashamed.
Feign or Fawn: The brain and body feel like the danger won't go away.
People who use the feign or fawn response may feel like they need to “convince” the danger to leave them alone. They may put other people’s needs ahead of their own and struggle to set healthy boundaries. They seem like a people-pleaser and strive to make other people’s happiness a top priority.
Being resilient, or resilience, means being able to deal with and quickly recover from a problem. Resilience allows individuals to be flexible when something happens. They can think about what happened to them and learn to how to change, respond, and heal.
Why is Resilience Important?
Resilience is important because it helps people deal with the bad things that happen to them. This means that people are strong enough to recover from difficult situations.
Resilience allows us to manage things in a healthy way and stay or get back on track when we are faced with difficult situations. When we have resilience, it means that we’re able to face difficult things and keep moving forward.
People with less resilience may use unhealthy ways to overcome tough times. This can often lead to more issues later. It can also make it difficult to fully recover from the stressful or traumatic event that happened in the first place.
How Do You Know if You’re Resilient?
Everyone is resilient but you can always learn, grow, and strengthen the resilience you have.
If you have ever fallen to the ground and were able to get it back up, then you’re resilient. Even if you had help getting back up, you still have resilience. Being resilient doesn’t mean only relying on yourself to get through difficult times but learning to lean on support systems to work through challenges when needed.
Becoming more resilient also doesn’t mean you won’t experience stress or any other difficult emotions anymore. However, it does mean that while you may experience difficult times in your life, you are able to cope with those situations and get stronger because of them.
The Resilient Zone
The Resilient Zone is when we are in a place to be able manage our feelings and thoughts. The Resilient Zone is also be called the “OK” Zone. Below is a picture to help explain the Resilient or “OK” Zone. The curved red line is our thoughts and emotions. The straight blue line is the edge of the Resilient or “OK” zone. If we are able to keep our thoughts and emotions inside the blue lines, we say we are “in the Resilient or “OK” Zone”.
We are able to have many different thoughts and emotions. When we are in the Resilient zone or “OK” Zone we can be sad, mad, happy, calm, worried, or distressed. We are able to manage the thoughts and feelings that we have when we are in the Resilient or “OK” Zone.
Sometimes things in our life can move us out of our Resilient Zone or “OK” Zone. When we are moved out of this zone it can make it harder for us to cope or do things in our life. We may react without thinking first. We may also do things that are harmful to ourselves or others.
Below is a picture showing what it might look like if someone moves out of their resilient zone. The green line is where the person is in their Resilient or “OK” Zone. The red lightning bolt is a stressful event in their life. The blue lines are the edges of their resilient zone.
We can learn ways to make our Resilient Zone or “OK” Zone bigger. The bigger our zone is, the more resilient we are. If the person above is able to build their resilience and make their Resilient or “OK” Zone bigger, they are able to handle stressful events and stay in their zone. Below is a picture of the same person as above who was able to make their zone bigger.
Introduction to Resilience Skills
Resilience skills are a set of skills that can help you to build your resilience and stay within the resilient or “OK” zone. There are six different resilience skills that can be practiced and used to widen your zone. The resilience skills can also help you monitor where you are in the zone and realize when you may be starting to feel stressed and get pushed toward the edges of your zone. These skills can be used alone or together to help you stay in or get back into your resilient zone.
Tracking: This skill helps someone figure out where they are in the resilient zone by paying attention to their thoughts and senses.
Resourcing: This skill can help when someone is near the edge of their resilient zone or if they’ve been bumped out of it, by paying attention to memories, people, places, things, and ideas that help them feel better.
Grounding: This is a good skill to use when someone is having trouble staying in their resilient zone by paying attention to things that are around them at the moment.
Gesturing: This is another skill someone can use to help move themselves away from the edges of their resilient zone by paying attention to their movements and using gestures to help them relax.
Shift and Stay: This skill is a powerful way to help someone stay in their resilient zone by learning to shift their own thoughts away from things that are bothering them to stay on neutral or happier thoughts.
Help Now!: This is a skill that can be used if someone is stuck outside their resilient zone. These strategies focus on calming their body and bringing them closer to their resilient zone.
Building a Self-Care Plan
A self-care plan can also be called a resilience plan and is a way to help you widen your resilient zone. As a support staff, it’s important for you to have your own self-care plan so that you are able to take care of your own needs so you can be healthy and support others.
Why is a Self-Care Plan Important?
Our minds work best when we are feeling calm and happy. If we are moving toward the edges of the resilient or “OK” zone our minds will not work as well.
A self-care or resilience plan can help you practice the resilience skills so that you can use them easily if you are being moved out of your zone.
When you are being moved out of your resilient or “OK” zone it can be very hard to decide what to do in that moment. Having a plan in place eliminates the need to make decisions, you just simply follow your plan.
What Should be Included in a Self-Care Plan?
The resilience or self-care plan should have information about what it looks and feels like when you are being pushed toward the edges of your resilient or “OK” zone. The resilience or self-care plan should have information about the resilience skills that are most helpful to you. This may include things like specific resources or gestures. A resilience or self-care plan can also have information like what to do in a crisis situation.
Recognizing and Managing a Mental Health Crisis
A mental health crisis means that a person’s feelings or problems are so strong that they cannot do what they need to do that day. A mental health crisis may also mean that the person is at risk of hurting themselves or others.
Signs of a mental health crisis:
These are some common signs that a person may be having a mental health crisis:
- Not able to do daily activities like bathing, brushing teeth, or changing clothes.
- Changes in mood, increased energy level, or restless
- Suddenly sad, withdrawn, not wanting to be around other people.
- Angry, verbal threats, violent, destroying property.
- Using drugs or other substances, self-harm like cutting, abusive behavior.
- Not able to recognize family or friends, confused, strange ideas, thinks they are someone they are not, hearing voices, seeing things that are not there.
How long does a mental health crisis last?
Sometimes a crisis will only last a few minutes, other times a crisis can last for days or months. It depends on how quickly the person is able to get help and the type of coping skills they have. If a person is able to widen their resilient or “OK” zone they may be able to recover from a mental health crisis more quickly.
What should I do if the person I support is having a mental health crisis?
The most important thing to do in a crisis is to tell someone, this could be talking to you as their DSP, a parent, friend, other support staff, therapist, or trusted adult. Encourage the person to be honest about the thoughts and feelings they are having. Be open and nonjudgemental and let them know you are there to support them. If they need more help, they can talk to a professional by calling or texting the National Suicide Helpline at 9-8-8. If they need immediate help to stay safe, you should call 9-1-1.
How can I help prevent a mental health crisis?
It is helpful to plan how to handle a crisis before it happens. Having a plan can help the person you support get through a mental health crisis more easily or even prevent a crisis from happening.
Their plan should include:
- A list of triggers that may cause a mental health crisis along with warning signs that a person may be having a hard time and need additional supports.
- Strategies to help them feel calm again. These can include things like the resilience skills, coping strategies they’ve learned from a therapist, or even simple things like going for a walk or listening to music. The strategies should be individualized for each person.
- Phone numbers for trusted adults and emergency providers.
You or a mental health professional can help them create a mental health crisis plan. They can also help them to learn and practice skills for managing their emotions.
Once a crisis plan has been developed, a copy of the plan should be available for all support staff and the individual to access when needed. This could mean keeping a printed copy in a common area, or even having a version that is able to be saved on a smartphone or tablet for easy access.
Other downloads
| Name | Description | Type | File |
|---|---|---|---|
| Understanding Trauma | Many people in the world have experienced trauma, which means that either yourself, a coworker, people you support, or a friend/family member has likely experienced a traumatic event. | Download file: Understanding Trauma | |
| Survival Circuit and PTSD | The survival circuit describes how the brain and body respond to threats. The survival circuit is a normal and natural part of being human. | Download file: Survival Circuit and PTSD | |
| The Four F's | When your brain detects a threat, your body will react to survive. It does not matter if the threat is real or not. There are four common ways people will react to threats: | Download file: The Four F's | |
| Understanding Resilience | Being resilient, or resilience, means being able to deal with and quickly recover from a problem. Resilience allows individuals to be flexible when something happens. | Download file: Understanding Resilience | |
| Resilient Zone | The Resilient Zone is when we are in a place to be able manage our feelings and thoughts. The Resilient Zone is also be called the "OK" Zone. | Download file: Resilient Zone | |
| Introduction to Resilience Skills | Resilience skills are a set of skills that can help you to build your resilience and stay within the resilient or “OK” zone. There are six different resilience skills that can be practiced and used to widen your zone. | Download file: Introduction to Resilience Skills | |
| Building a Self-Care Plan | A self-care plan can also be called a resilience plan and is a way to help you widen your resilient zone. As a support staff, it’s important for you to have your own self-care plan so that you are able to take care of your own needs so you can be healthy and support others. | Download file: Building a Self-Care Plan | |
| Recognizing and Managing a Mental Health Crisis | A mental health crisis means that a person’s feelings or problems are so strong that they cannot do what they need to do that day. A mental health crisis may also mean that the person is at risk of hurting themselves or others. | Download file: Recognizing and Managing a Mental Health Crisis |
This information was developed by the Autism Services, Education, Resources, and Training Collaborative (ASERT). For more information, please contact ASERT at 877-231-4244 or info@PAautism.org. ASERT is funded by the Bureau of Supports for Autism and Special Populations, PA Department of Human Services.