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RISE Program
Healing, evolving, resilience building
I. RISE Program Mission & Philosophy
Mission: To move beyond treating symptoms to healing the root causes of distress. We shift the clinical question from “What is wrong with you?” to “What happened to you, and how can we support your growth?” This is the core of the RISE Program.
| Week | Module Theme | Focus Skill |
|---|---|---|
| 1-2 | Safety & Stability | Creating a physical and emotional safety plan. |
| 3-4 | Emotional Regulation | Identifying triggers and “riding the wave” of emotion. |
| 5-6 | Self-Compassion | Addressing the inner critic; distinguishing guilt vs. shame. |
| 7-8 | Connection | Healthy boundaries; asking for help; trusting others. |
| 9-10 | Meaning Making | Post-traumatic growth; rewriting the personal narrative. |
The 6 Pillars of Practice (Based on CDC/SAMHSA guidelines):
- Safety: Physical and psychological safety is the priority.
- Trustworthiness & Transparency: Operations are clear; trust is earned, not expected.
- Peer Support: Shared experience is utilized as a tool for healing.
- Collaboration & Mutuality: Healing happens with the client, not to them.
- Empowerment & Choice: Restoring power to the client is the antidote to trauma.
- Cultural, Historical, & Gender Issues: Acknowledging systemic trauma and bias.
II. Phase 1: The Foundation (Staff & Environment)
Before accepting patients, the clinic must embody TIC. You cannot offer trauma-informed care with a burned-out or non-regulated staff.
A. Environmental Design
The physical space is the first intervention. It must reduce the “fight or flight” response immediately upon entry.
- Sight: Cool colors (sage, blues), natural light, minimal clutter. Avoid “institutional” aesthetics.
- Seating: Positioning chairs so clients can see the exit (empowerment) and have their back to a wall (safety).
- Sound: Soundproofing is non-negotiable to ensure privacy and safety.
B. Staff Training & Wellness
- Universal Training: Receptionists, billing staff, and janitors are trained in TIC, not just clinicians. Everyone understands that a “difficult” patient is likely a dysregulated patient.
- Secondary Trauma Prevention: Mandatory monthly “Clinician Resilience” groups to process vicarious trauma and prevent compassion fatigue.
III. Phase 2: The Patient Journey
Step 1: The “Soft” Intake
Traditional intakes can be re-traumatizing. We use a Staged Intake Process.
- Session 1: Focus solely on building rapport and immediate safety planning. No “deep dives” into trauma history yet.
- Consent: Radical transparency about what therapy involves, allowing the client to say “stop” or “no” at any time without consequence.
Step 2: Regulation Before Processing
Trauma therapy cannot happen if the client is outside their “Window of Tolerance” (either hyper-aroused/panicked or hypo-aroused/numb).
The Protocol:
- Stabilization: Clients learn to identify where they are in the window.
- Grounding: Teaching somatic tools (breathing, 5-4-3-2-1 technique) to return to the optimal zone.
- Processing: Only once regulation is achieved do we move to trauma processing.
IV. Phase 3: Clinical Modalities
The RISE program utilizes a “Bottom-Up” approach, addressing the body/nervous system first, then the mind.
1. Somatic & Sensory Therapies (Bottom-Up)
- Somatic Experiencing (SE): Focuses on releasing physical tension that remains in the body after trauma.
- Yoga for Trauma: A dedicated weekly group focusing on gentle movement to help patients befriend their bodies again.
2. Cognitive & Processing Therapies (Top-Down)
- EMDR (Eye Movement Desensitization and Reprocessing): For processing specific traumatic memories.
- TF-CBT (Trauma-Focused Cognitive Behavioral Therapy): For reframing cognitive distortions related to the trauma (e.g., “It was my fault”).
VI. Measuring Success
We measure progress not just by symptom reduction, but by functional resilience.
- The ACE Score (Adverse Childhood Experiences): Used cautiously at intake (if appropriate) to understand context.
- The CD-RISC (Connor-Davidson Resilience Scale): Administered at Intake, Week 5, and Discharge to track improvements in resilience.
- Client Feedback Forms: Administered after every session (e.g., “Did you feel heard today? Did you feel safe?”).
