RESPONDING TO TRAUMA & PTSD
About Expressive Trauma Integration™
Expressive Trauma Integration™ (ETI) is an integrative therapy approach that draws on recent research and practice from the fields of neuroscience, attachment and developmental psychology, expressive therapies, experiential and body-oriented therapies, cognitive reframing, behavioral modifications, mindfulness, and nutritional psychology.
Expressive Trauma Integration™ (ETI) approach is based on over a decade of research and clinical work with traumatized populations in the Middle East, United States, Africa, and Asia by Dr. Odelya Gertel Kraybill, an integrative trauma psychotherapist, and consultant. A modular approach suitable for both psychosocial and trauma therapy interventions, ETI is an integrative framework that draws on recent research and practice from the fields of neuroscience, attachment and developmental psychology, expressive therapies, experiential and body-oriented therapies, cognitive processing, behavioral modifications, mindfulness, and nutritional psychology.
ETI has been field-tested and revised in trainings provided to social and community workers, therapists, first responders, and students, in Lesotho, S. Africa, S. Korea, Philippines, US, Canada, Israel, Japan and China. The ETI training model was formally accepted by the Philippines Department of Health in 2014 as one of their key modules of response to communal trauma after crisis.
ETI combines psychoeducation, experiential methods, and an individualized sustainability plan (ISP). Together, these enable clinicians and trauma survivors to:
*learn what happens to people after trauma or cumulative stress, at neurobiological, emotional, physical, spiritual, and social levels;
*explore a six-stage framework for understanding trauma response and the path to integration;
*map out an individual's encounters with trauma across life in a timeline that includes personal challenges and stress triggers;
*create and experiment with a self-sustainability plan (manage routines);
*practice the use of evidence-based modalities and techniques (bottom-up and top-down) to promote trauma integration.
Psychoeducation about trauma is education about the cognitive, physical, emotional, spiritual and social effects of trauma on survivors and families (individual trauma) and communities (communal trauma).
Six Stage Trauma Integration Roadmap provides a clear conceptual framework for understanding and responding to trauma. The ETI approach helps survivors describe their experience in stages of:
1-Routine, 2-Event, 3-Withdrawal, 4-Awareness, 5-Action, 6-Integration; and determine their current status. When they are ready and in the safety of a therapeutic setting, the roadmap guides in exploring options for further steps towards trauma integration.
Experiential modalities and methods (bottom-up). Studies assert that traumatic memories are stored in locations in the brain that can’t be accessed by cognitive approaches and require engagement via lower parts of the brain. Whereas talk based and cognitive approaches work top-down and seek to enlist higher parts of the brain in calming the more primordial functions of the lower brain, nonverbal approaches work bottom-upwards by engaging directly with the lower parts of the brain and expanding from there till the client is ready to engage in top-down narrative processing and trauma integration.
The ETI approach focus on the use of tools and techniques that facilitate sensory and bilateral integration, enhance vagal-tone, and promote neuroplasticity and neurogenesis.
Individualized Sustainability Plan (ISP). Setbacks after encouraging progress are common for trauma survivors. An ISP made up of techniques and practices tailored to their own unique situation is essential to enable trauma survivors to sustain progress achieved at spiritual, physical, cognitive and emotional levels. ISPs draw from various practices demonstrated to be effective in mitigating trauma symptoms and enhancing self-regulation. These include: mindfulness and self-compassion practices, sensory and bilateral integration, sport and movement, (top-down) cognitive reframing & behavioral modifications, expressive arts, brain-training neurofeedback, diet and nutrition.
Download a free ETI infographic ETI trauma integration framework
Download a free ETI infographic ETI trauma integration roadmap
I really appreciate how much you put into each training. Having been a trainer I know it takes an enormous amount of presence to hold a group our size and to keep us engaged like you do.
I feel like I have a new and much more expanded understanding of trauma and now have some tools to help to hold the people I work with much more tenderly and with more knowledge. I thank you for sharing the depth of your wisdom and the exquisite care you hold those with you are working.
ETI Series I workshop participant
The workshop was amazing. The experiential activities keep things engaging. I used the Squared Breathing technique to assist clients in a mindfulness activity and even used some of the grounding exercises. It was an extremely useful workshop. I am definitely going to take some more to build on the techniques and understanding until I have integrated them into everyday practice.
Leah Reed LCPC Participant in ETI Series I workshop