How is your workforce doing today?

Are they functioning at their best, or are they burned out?

The ability to manage and recover from stress is crucial for resiliency and cognitive, medical, mental, and social health. Burnout is the enemy of productivity, creativity, and overall business success. Until recently, it was difficult for leaders to get reliable data on people’s ability to perform at their best and understand levels of burnout within the business. The Heart(beat) of Business presents the science behind peak performance and how stress and burnout destroy people’s health and devastate business outcomes.

Due to recent technological advancements, a leader can use a biometric called heart rate variability (HRV) to get daily, weekly, and monthly data on the health and wellness of their workforce. HRV data provides leaders with an understanding of the capacity their people have to perform at their best.

The Heart(beat) of Business gives leaders and businesses a roadmap for implementing and using biometric data to measure and address burnout. It also provides a set of best-practice strategies using HRV data to improve cognitive, medical, mental, and social health crucial for business success.

If your business relies on people for success, becoming an early adopter of HRV will help you create a business environment that outperforms any competition.

How do you quantify the mental, physical, social, and cognitive health of people and organizations?

Heart rate variability or HRV is the answer. HRV is a biometric that measures the differences in successive heartbeats. While simple, HRV provides an incredible amount of information on the health of our autonomic nervous system and brain.

In recent years, HRV variability monitors have become smaller and very affordable. A simple smartphone application takes the data from the monitors, applies algorithms, and provides users with accurate data on their mental, physical, social, and cognitive health and wellness. Heart Rate Variability explores how professionals and organizations can implement HRV to track the psychological, social, and physical health of those they serve, their staff, and the organization.

While those in any industry will benefit from this book, Heart Rate Variability contains chapters specific to organizations striving to integrate trauma-informed practices and research. HRV helps demonstrate the terrible impact of trauma. Without treatment and support, trauma devastates the brain and nervous system, making emotional regulation and insight difficult. More importantly, HRV tracks the trauma healing process or post-traumatic growth, building motivation as a person sees how their work and treatment are improving their health. HRV becomes a practical and powerful tool that, with proper implementation, helps change the lives of those struggling in our communities.

HRV improves the efficiency and effectiveness of the work of professionals and organizations by providing them with daily feedback on the people they are striving to help. Even before achieving a tangible traditional outcome or reaching a goal, a person will see progress through improving HRV scores over time. This success builds motivation and confidence to take on bigger and bigger life challenges. A drop in HRV scores alerts the professional to provide support and reach out earlier than they might normally. The alert and early action that HRV allows can prevent one bad day from cycling into larger, more dangerous issues such as suicide, relapse, or harming another.

Heart Rate Variability demonstrates how HRV will revolutionize how people and organizations approach self-care and staff wellness. The ability to create and maintain healthy working relationships with those in services is one of the most powerful predictors of successful outcomes. To accomplish this task for people with histories of abuse, neglect, and painful relationships takes a tremendous amount of compassion, empathy, and patience.

While the work of helping others is gratifying, social workers, teachers, mental-health workers, physicians, nurses, and other helping professionals dominate the top occupations for burnout in our society. Daily HRV measurements provide insight and focus on self-care. Before HRV, burnout was a relatively subjective measure. HRV quantifies burnout and demonstrates how self-care strategies improve wellness and performance.

Staff turnover and high levels of burnout make creating and maintaining a high-performing helping organization extremely difficult. HRV can provide organizations with a daily measure of the health and wellness of their staff, teams, and the entire organization. It provides a quantifiable answer to the question, “What is the organization’s health today?” Getting HRV measures from staff allows managers to support staff self-care and determine the effectiveness of organizational initiatives to improve staff health and lower turnover.

Most helping organizations operate in a marketplace with a scarcity of funding, resources, and staff capacity. HRV helps management ensure that the organization is positioning interventions and resources in the most effective way possible to improve the health and functioning of those they serve. Increases in efficiency and quality will help organizations create sustainability and show the effectiveness of service, helping to secure future funding.

Today, in every community around the world, something is going to happen to an innocent child. If left untreated, this single event will threaten to drastically increase the chance that the child will get cancer, an autoimmune disease, diabetes, or a sexually transmitted infection such as HIV. Besides medical issues, these children are also more likely to fail in school, become involved in the criminal justice system, experience homelessness, develop mental illness and drug addictions, struggle with unemployment and poverty, and experience domestic violence. Ultimately, the child is at risk of losing 20 years off their life expectancy.

Thankfully, this child will walk into a school tomorrow. Ideally positioned to identify what happened to the child and facilitate treatment, schools play a unique and life-saving role in the future health and well-being of these children. Those lucky enough to get proper support and treatment not only dramatically lower their risk for the psychological, medical, and social risks listed above, they transform their pain and suffering into a powerful type of resilience that serves them well throughout the rest of their lives.

What is this powerful event? Childhood trauma. The majority of students will experience some form of emotional, physical, or sexual abuse, neglect, family struggles or dysfunction, racism, homelessness, or poverty by their eighteenth birthday, potentially robbing them of their ability to thrive academically and establish a meaningful quality of life. Our growing knowledge of trauma is a call to action for every person that works in education and cares about the children in their community.

Trauma-Sensitive Early Education: Helping Pre-School & Elementary Students Thrive! demonstrates the devastating effects that trauma inflicts on students, and how the resulting anguish manifests in the classroom as academic and behavioral struggles. Understanding the problem is just the first part of the journey taken in the book. This in-depth exploration guides educators in the process of creating dynamic classrooms and lessons that help students with trauma experience social and academic success.

Current educational approaches work well for most students coming from stable healthy homes with economic stability and the skills necessary to succeed socially and academically. Unfortunately, the students who are left behind struggle, not because of a lack of motivation or some conscious desire to misbehave, but because the current system is not designed to identify and help treat the root cause of their struggles. These kids are not “bad kids”; they are victims of untreated traumatic events that happened to them due to no fault of their own.

Students with untreated trauma lack the skills to succeed in current models of academic instruction and behavioral management. Without an understanding of the effects of trauma, educators focus on the behaviors, thus missing opportunities to connect the student to resources and to help them build the skills they failed to learn at home. The great news is that the trauma-sensitive approaches put forth in Trauma-Sensitive Early Education are best practices for all students, improving the educational experience for everyone.

After helping educators establish trauma-sensitive classrooms, the book examines school-wide strategies and behavioral-management approaches that help create a safe environment, while simultaneously getting help for students with trauma. Traditional models punish, suspend, and retraumatize students, furthering the psychological, academic, and social struggles. A shift in paradigms provides real solutions that help solve the underlying problems, improve school performance, and create ideal learning environments for all students.

Finally, the book will further examine the need to reform an antiquated educational system that is failing too many students and communities. Traditionally, students with trauma quickly fall into pipelines to prison and poverty. Understanding trauma’s impact helps us understand that it is not these kids that are failing in our schools; instead, our schools and traditional approaches to education are failing these students.

Trauma-Sensitive Early Education provides a complete guide for teachers, school administrators, parents, policy-makers, and all those who care about children and education, by providing a desperately needed paradigm shift in philosophy and approach. Once people understand that students who struggle do so because they are victims of a treatable condition, it serves as a wake-up call to ensure that every child gets the support and education they need to live a meaningful life. So many of the larger social problems facing our communities result from these students failing to get the help they need during their critical developmental years

This supplement has four parts. Part 1: Setting the Stage provides a brief overview of Connecting Paradigms: A Trauma-Informed & Neurobiological Framework for Motivational Interviewing Implementation. The first chapter serves as a quick refresher of the concepts presented in Connecting Paradigms. The second chapter explains the best way to implement the material in this book.

Part 2: Talking about Trauma explores different analogies and models to help clients learn and reflect on their lives and traumatic pasts. There is incredible power in helping someone understand how their traumatic past is affecting them in the present. This material is liberating in that it helps people to realize many of their struggles are due to past trauma and not something inherently wrong with them as a person. In addition, the knowledge motivates many to engage in mental-health services in order to heal from their past suffering and get their children help as well. Analogies and models are effective in teaching about trauma in a safe way that minimizes the chance of retraumatization.

The third section, Part 3: Talking about Change, provides several analogies and models that complement the Motivational Interviewing (MI) approaches presented in Connecting Paradigms. The focus of Part 3 is on how to help clients understand the change process and the neurobiological adjustments needed to support behavioral change. The analogies and models are a great way to build mindsight and elicit change talk.

The final section, Part 4: The Hero’s Journey, presents a model that brings together critical aspects of the healing and change process. This model helps people identify where they are in their journeys to healing and growth and what they need to focus on to successfully take their next step. The hero’s journey provides many great opportunities for us to help people gain self-understanding while eliciting change talk about living the life they desire.


One of the most important scientific advancements of the past few decades is our increased understanding of the brain and the impact of our environment on this complex neurobiology. This new volume by some of the leading experts in the field compiles a comprehensive overview of the core issues we need to understand affecting the neurobiology, neuroscience and the assessment and treatment of sexually abusive youth as well as the child and adolescent victims of sexually abusive and aggressive behavior.

Co-wrote Chapter 7: Neuroscience Applied to the Therapeutic Milieu with my mentor and friend, Jerry Yager, Psy. D. This book was an honor to be a part of both due to the great content and impressive author list.

Chapter 1: The Trauma-Informed Paradigm

Two-thirds of people in your community experienced something that potentially results in decreased life expectancy, cancer, HIV, poverty, incarceration, domestic violence, and homelessness. The experience at the root of all these social and public health issues is psychological trauma. For some, trauma is an event that causes temporary pain and suffering and, if provided the right support, eventually results in increased levels of resiliency (Centers for Disease Control and Prevention, 2016).

Unfortunately, most people experiencing homelessness, extreme poverty, mental health struggles, incarceration, and addiction never had an opportunity to heal and recover, resulting in a life dominated by the pain and suffering of trauma. Just as we should not blame the person for having trauma inflicted on them, we should not blame them for the behaviors, mental health issues, medical issues, and social struggles resulting from traumatic experience if we do not get them the help they need to recover. Our challenge is to help those people in a way that stops the pain and gives them an opportunity to live the lives they deserve.

Chapter 2: Trauma and Human Development

Human beings are social creatures. We thrive in healthy relationships. Unfortunately, most trauma occurs when one person with power violates the dignity of another person, inflicting tremendous pain and suffering. When relationships, especially in childhood, that should be nurturing and supportive become dangerous and traumatic it disrupts healthy brain development. Through the process of epigenetics, neurogenesis, and pruning the brain adapts to traumatic environments in a way that supports survival and reactivity (Bloom & Farragher, 2011; Bloom, 2000)

Overdevelopment of survival areas of the brain comes at a cost as the areas associated with emotional regulation and cognitive ability weaken. An unfortunate effect of being in traumatic relationships and situations is that people establish a relationship template believing that all people are potential sources of harm. The good news is that if someone with compassion and patience can build a healthy relationship with the individual, the brain can heal and relationship templates change as the client sees that not all people are bad and out to hurt them (Nakazawa, 2016; Ogden, Minton, & Pain, 2006).

Chapter 3: The Brain and Trauma

Unhealed trauma becomes a biological injury. The brain adapts to survive traumatic situations and high-stress environments. While this adaptation promotes survival, the person will struggle with activities necessary for success in academics and employment. Without the right type of assistance, the neurobiological impact of trauma often results in behaviors and ways of thinking and feeling that keep people stuck in unhealthy situations. A basic understanding of the brain demonstrates the devastation of trauma and why trauma can negatively affect a client’s ability to realize the life they want to live (Nakazawa, 2016; Ogden, Minton, & Pain, 2006).

Chapter 4: Basics of Motivational Interviewing

William R. Miller and Stephen Rollnick (2012), the founders of M, provide this definition of their approach:

“Motivational Interviewing is a collaborative, goal-oriented style of communication with particular attention to the language of change. It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person’s reasons for change within an atmosphere of acceptance and compassion.”

Delivered upon the foundation termed the Spirit of MI, MI delivery focuses on creating partnerships, evoking the expertise that lies within the client, accepting that the client is where they are in life and working from that point, and approaching our work with compassion. Utilizing the Spirit of MI, its strategies provide an ideal intervention for those struggling with past trauma. MI is a best practice which helps reach through the pain and suffering of trauma and supports the client in a way that promotes change and healing (Miller & Rollnick, 2012; Murphy, 2008).

Chapter 5: The Mind and Stages of Change

“Losing one’s mind” is a real consequence of trauma. The neurobiological damage of trauma makes it difficult for people to control their emotions and behaviors. People struggling with homelessness, extreme poverty, violence, addiction, and other intense issues face making many changes to improve their situation. Those helping them need a strategic way to assess where to begin conversations around change. Understanding how the mind can gain control of emotions and behaviors is a critical step in the journey to change and healing. Stages of change provides a structure to conceptualize the change process and implement interventions that help client effectively navigate their change while avoiding common pitfalls that can lead to disengagement and resistance (Siegel, 2016; Schwartz & Begley 2002; Prochaska, DiClements, & Norcross, 1992).

Chapter 6: MI Process Engage

The greater the client’s engagement in their change and the services designed to help them accomplish their change, the more likely they are to achieve positive results. Unfortunately, many traditional approaches diminish engagement, lead to resistance, or, even worse, results in people dropping out of services altogether. MI uses four communication approaches, open-ended questions/statements, affirmations, reflections, and summaries to build and maintain engagement and strengthen the helping relationships. These approaches are simple to learn and implement and are utilized heavily in all the strategies presented in the book (Miller & Rollnick, 2012).

Chapter 7: Trust and Safety

Motivational Interviewing and trauma-informed practices rely heavily on the trust and safety established between the client and us. Due to the pain and suffering inflicted on the client during traumatic experiences, building trust and psychological safety are difficult. To make matters worse, many people are in precarious physical situations due to experiencing homelessness, domestic violence, food scarcity, and community violence. Without trust and safety, the brain will focus on ways to best promote short-term survival, which comes at the expense of focusing on changes that would improve their condition in the long-term. Building trust and safety necessitates integrating trauma-informed approaches that promote both physical and psychological safety. (Bloom & Farragher, 2013; Bloom, 2006; Stanley & Brown, 2012).

Chapter 8: MI Process Focus

Past suffering, lack of safety, unhealthy relationships, and the inability to see a better future all diminish a client’s ability to focus on their change and future. MI and harm reduction are two approaches that help both us and the client focus attention on things that will eventually result in long-term change. Meeting the client where they are at in life, realizing that a client is not the embodiment of the sum of their problems, increasing safety by reducing harm, and taking a nonjudgmental approach are strategies of harm reduction, MI, and trauma-informed approaches. These all promote the client’s ability to focus on more than just their survival (Miller & Rollnick, 2012; Marlatt, Larimer, & Witkiewitz, 2012; Roe, 2005).

Chapter 9: Mindfulness

The practice of mindfulness is changing traditional views of the healing process and leading to breakthroughs in psychology and other related fields. In the book, mindfulness is presented as an activity and set of skills that help heal the traumatized brain and support the change process. While the research behind the benefits of mindfulness is substantial, many in the helping professions have struggled to introduce and practice mindfulness with the people they are serving. As a complementary tool to MI, mindfulness strengthens neurobiological processes that promote healing and change (Langer, 2009; Parnell, 2008).

Chapter 10: MI Process Evoke

The motivation for change comes from within the client. Each client is an expert on themselves and their situation. The success of any change comes out of this expertise. The more a client talks about a change, the more likely that the change will happen. MI provides a set of approaches that elicit talk about a change in a way that helps people progress through the stages of change. These approaches allow people to explore their desire, reason, and need to change, while at the same time, building their confidence that they can make their change a reality. Motivation builds through this exploration, eventually leading to action (Miller & Rollnick, 2012).

Chapter 11: Mindsight

Mindsight is a deep level of insight into a client’s situation which brings forth motivation for action. Mindsight helps clients see their ambivalence, wanting more than one thing when those things are incompatible, concerning their change. While ambivalence can feel uncomfortable, this feeling creates a type of stress called cognitive dissonance, which occurs when a client realizes that they are living a life not aligned with their values or morals. Cognitive dissonance creates motivation for meaningful change as the client attempts to alleviate it from their lives. The last aspect of mindsight is to move from cognitive dissonance to motivation and towards a pathway forward eliciting hope for a better future. Put together, the steps of mindsight are potent tools for transformation and change (Siegel, 2011; Dweck, 2006).

Chapter 12: MI Step Plan

A plan is a set of actions and tasks that help a client move out of their current state into a better future. Few people in stressful situations possess the ability to plan in isolation. Assisting clients to create goals and objectives to improve their safety, reduce stress, and change their condition is central to the process of healing and change. While planning can seem simple on the surface, implementing it in accordance with MI, harm reduction, and trauma-informed approaches requires skill and thought (Miller & Rollnick, 2012; Stanley & Brown, 2012).

Chapter 13: Post-traumatic Growth

Overcoming the pain and suffering of trauma is an opportunity to gain resiliency, strength, and wisdom. This transformation is called post-traumatic growth. Everyone’s journey to post-traumatic growth is unique which challenges those helping them to find the right mix of support, strategies, and resources. One change leads to another and another; confidence builds, futures become filled with hope and lives are transformed. The journey to post-traumatic growth for many is lengthy and requires overcoming difficult barriers, but the result for the client is nothing short of life-changing (Siebert, 2005).