Complex Traumas and Trauma-Informed Care Principles and Practices

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NAME:
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Complex Traumas and Trauma- Informed
Care Principles and Practices- A Video
Scenario
Introduction
Complex traumas require trauma informed care for effective mental health nursing care.
Informed trauma is a treatment framework that treats the whole person and takes accounts of past
trauma and results of coping mechanism in attempts to understand behaviour and treat a trauma
patient (Muskett, 2014). Informed trauma care involves an organizational structure that
understands, recognizes, and responds to effects of all traumas. Mental health care provision
requires a multidisciplinary team that comprehensively contribute to the understanding,
recognition, and respond to a patient mental health care plan.
The following essay in a video scenario with a potential development of problematic substance
use that interact with mental health concerns. Lisa, the patient in the scenario is a regular
cannabis users and period speed user. The patient who was earlier been admitted to psychiatrist
hospital, has stopped using is anti-psychotic medication. Lisa has been seeing Jenny, the assessor
for the past six. Lisa tells Jenny that she feels unsafe and she has been hearing voices that make
her feel the need to protect herself. The write up with identify and discuss issues in the video
scenario that contributed to problematic substance using trauma-informed care and practice. The
essay will also identify how the mental health nurse can collaborate with the patient in the issues
outlined and a critical discussion on how the nurse can engage the patient and multidisciplinary
team in mental health for collaborative care planning.
Issues that contribute to problematic Substance use
The three issues demonstrated in the video that contribute to problematic substance use are;
history of mental illness and not taking anti-psychotic medication, a feeling of being neglected
by parents after moving in by boyfriend and stopping communication, and thoughts of harm
from domestic violence with the boyfriend and need to keep herself safe. These contributing
issues to problematic substance use can be discussed by trauma-informed approach to understand

how they impact the patient’s health. The issues are therefore discussed on how they affect
patient’s appearance, perception, cognition, formulation, insight and judgement, moods and
affect, thinking, behaviour, action, and speech and language.
First Lisa appearance was different as she dressed a pair of jeans that were dirty and a t-shirt.
Lisa was known to dress smartly with clean clothes. The changed Lisa’s appearance shows that
her condition is affecting how she dresses which is an indication of deteriorating mental health.
Secondly, Lisa behaviour is restless and agitated and keeps playing with her hair. Lisa has an
intermittent eye contact and she got distracted several times and seemed to respond to unseen
voices. According to Gomez (2018) psychosis affects a person’s reality and makes them feel like
they are in a wonderland that disconnects them to the very reality around them. He also noted
that psychosis can be experienced in short episodes that recurrently change a patient behaviour
alternating reality with non reality. Lisa therefore was experiencing her past mental health
condition that is as a result of stopping to take her anti-pschytonic medication. Thirdly, Lisa
mood and affect appear to be fearful, anxious and agitated. Lisa has thoughts of harm that she
feels unsafe causing her to be fearful and agitated. Goodman et al. (2016) stated that repeated
thoughts cause anxiety to an individual. The unwanted thoughts of harm seem to come from
nowhere and cause a big deal of anxiety for Lisa. Fourth, Lisa thinking is paranoid and
delusional. Though Lisa was able to express herself clearly, she seemed to get distracted and
sometime pausing in the middle of a sentence. There appeared to be unseen stimuli that
distracted her concentration and she had to be helped to refocus on the conversation. Lisa
believes that she is being spied by cameras and her boyfriend has inserted a transmitter into her.
She also thinks that her thoughts are monitored. This makes Lisa to sleep in the garden shed and
thinks it is important for her to protect herself. Lisa has thoughts of harm to her body and others
and thinks her boyfriend will harm her. She then sleeps in the garden shed and places a kitchen
knife under a pillow as a weapon to defend herself. According to Bogenschutz et al. (2014)
paranoid thoughts persistent and irrational feeling that someone or some people are out to getting
you. Fifth, Lisa’s perception has been impacted by auditory hallucinations. She says that she
heard horrible voices that she isn’t good and that she is ugly. Meddings, Byrne, Barnicoat,
Campbell, and Locks (2014) noted that auditory hallucinations cause derangement of a normal
function that affects a patient’s perception. The sixth approach to informed trauma is cognition
of the patient. Lisa reported that she had misplaced her medication and she was not able to