{"id":1221,"date":"2017-11-02T14:42:09","date_gmt":"2017-11-02T05:42:09","guid":{"rendered":"http:\/\/chienowa.org\/?p=1221"},"modified":"2018-02-03T10:46:08","modified_gmt":"2018-02-03T01:46:08","slug":"%ef%bc%94%e3%81%a4%e3%81%aer%ef%bc%88%e3%81%be%e3%81%9a%e5%82%99%e3%81%88%e3%82%8b%e3%81%b9%e3%81%8d%e3%81%93%e3%81%a8%ef%bc%89%e3%83%bc%e3%83%88%e3%83%a9%e3%82%a6%e3%83%9e%e3%82%a4%e3%83%b3%e3%83%95","status":"publish","type":"post","link":"https:\/\/chienowa.org\/?p=1221","title":{"rendered":"\uff14\u3064\u306eR\uff08\u307e\u305a\u5099\u3048\u308b\u3079\u304d\u3053\u3068\uff09\u30fc\u30c8\u30e9\u30a6\u30de\u30a4\u30f3\u30d5\u30a9\u30fc\u30e0\u30c9\u30a2\u30d7\u30ed\u30fc\u30c1\u5165\u9580 4"},"content":{"rendered":"<p>\u524d\u56de\u306fSAMHSA\u306e\u30ac\u30a4\u30c0\u30f3\u30b9\uff08<a href=\"https:\/\/www.health.ny.gov\/health_care\/medicaid\/program\/medicaid_health_homes\/docs\/samhsa_trauma_concept_paper.pdf\">PDF<\/a>\uff09\u304b\u3089\u300c<a href=\"http:\/\/chienowa.org\/?p=985\">\u30c8\u30e9\u30a6\u30de\u3068\u306f\u4f55\u304b\uff1f<\/a>\u300d\u3092\u898b\u307e\u3057\u305f\u3002\u5f15\u304d\u7d9a\u304d\u30ac\u30a4\u30c0\u30f3\u30b9\u3092\u8aad\u3093\u3067\u884c\u304d\u307e\u3057\u3087\u3046\u3002<\/p>\n<p>\u30c8\u30e9\u30a6\u30de\u306e\u69cb\u6210\u8981\u7d20\u306e3\u3064\u306eE\u306b\u7d9a\u3044\u3066\u3001\u30c8\u30e9\u30a6\u30de\u30a4\u30f3\u30d5\u30a9\u30fc\u30e0\u30c9\u306a\u30b5\u30fc\u30d3\u30b9\u304c\u307e\u305a\u5099\u3048\u308b\u3079\u304d\u3053\u3068\uff08assumptions\uff09\u3068\u3057\u3066<strong>4\u3064\u306eR<\/strong>\u304c\u6319\u3052\u3089\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n<p><strong>R<\/strong>ealize\uff08\u7406\u89e3\u3059\u308b\uff09\u3001<strong>R<\/strong>ecognize\uff08\u6c17\u3065\u304f\uff09\u3001<strong>R<\/strong>espond\uff08\u5fdc\u7b54\u3059\u308b\uff09\u3001<strong>R<\/strong>esist\uff08\u62b5\u6297\u3059\u308b\uff09<\/p>\n<p>\u306e4\u3064\u3067\u3059\u3002<\/p>\n<h2>\u30c8\u30e9\u30a6\u30de\u3092\u7406\u89e3\u3059\u308b\uff08Realize\uff09<\/h2>\n<p>\u307e\u305a\u6700\u521d\u306b\u6765\u308b\u306e\u304cRealize\u3001\u7406\u89e3\u3059\u308b\u3053\u3068\u3067\u3059\u3002<\/p>\n<p>TIA\u3067\u5927\u4e8b\u306a\u3053\u3068\u3001\u305d\u308c\u306f\u7d44\u7e54\u3067\u3042\u308c\u30d7\u30ed\u30b8\u30a7\u30af\u30c8\u3067\u3042\u308c\u3001<strong>\u95a2\u4fc2\u8005\u3059\u3079\u3066\u304c\u30c8\u30e9\u30a6\u30de\u3092\u7406\u89e3\u3057\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044<\/strong>\u3053\u3068\u3067\u3059\u3002\u6cbb\u7642\u8005\u3084\u5c02\u9580\u8077\u3060\u3051\u3067\u306f\u306a\u304f\u3001\u3059\u3079\u3066\u306e\u30b9\u30bf\u30c3\u30d5\u3001\u69cb\u6210\u54e1\u306b\u30c8\u30e9\u30a6\u30de\u7406\u89e3\u304c\u5fc5\u8981\u3067\u3059\u3002\u305f\u3068\u3048\u3070\u75c5\u9662\u306a\u3089\u6848\u5185\u3084\u53d7\u4ed8\u306e\u30b9\u30bf\u30c3\u30d5\u3001\u770b\u8b77\u5e2b\u3001\u533b\u5e2b\u3001\u306a\u3069\u3001\u75c5\u9662\u306b\u5165\u3063\u3066\u304b\u3089\u51fa\u308b\u307e\u3067\u306e\u3059\u3079\u3066\u306e\u30b9\u30bf\u30c3\u30d5\u304c\u30c8\u30e9\u30a6\u30de\u3092\u7406\u89e3\u3057\u3066\u3044\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093\u3002<\/p>\n<p>\u30c8\u30e9\u30a6\u30de\u306b\u3064\u3044\u3066\u4f55\u3092\u7406\u89e3\u3057\u3066\u304a\u304f\u3079\u304d\u306a\u306e\u3067\u3057\u3087\u3046\u304b\u3002<\/p>\n<div class=\"arconix-toggle-wrap\"><div class=\"arconix-toggle-title toggle-closed\"><i class='fa fa-plus-square'><\/i>\u539f\u6587\u304b\u3089\u5f15\u7528 \u30af\u30ea\u30c3\u30af\u3059\u308b\u3068\u958b\u304d\u307e\u3059<\/div><div class=\"arconix-toggle-content\">\n<blockquote><p>People\u2019s experience and behavior are understood in the context of coping strategies designed to survive adversity and overwhelming circumstances,<\/p><\/blockquote>\n<\/div><\/div>\n<p><strong>\u4eba\u306e\u7d4c\u9a13\u3084\u884c\u52d5\u3092\u56f0\u96e3\u3084\u904e\u9177\u306a\u74b0\u5883\u3092\u4f55\u3068\u304b\u751f\u304d\u5ef6\u3073\u308b\u3084\u308a\u65b9\u3068\u3057\u3066\u7406\u89e3\u3059\u308b<\/strong>\u3001\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u305d\u306e\u56f0\u96e3\u306f\u3001\u5b50\u3069\u3082\u6642\u4ee3\u306e\u8650\u5f85\u306e\u3088\u3046\u306b\u904e\u53bb\u306e\u3082\u306e\u3082\u3042\u308c\u3070\u3001\u30b9\u30bf\u30c3\u30d5\u304cDV\u88ab\u5bb3\u306b\u906d\u3063\u3066\u3044\u308b\u3068\u3044\u3046\u73fe\u5728\u306e\u3082\u306e\u3082\u3042\u308a\u307e\u3059\u3002\u307e\u305f\u652f\u63f4\u8005\u306e\u4ee3\u7406\u30c8\u30e9\u30a6\u30de\u3082\u3042\u308a\u307e\u3059\u3002<\/p>\n<p><strong>\u7406\u89e3\u304c\u96e3\u3057\u3044\u884c\u52d5\u3001\u7570\u5e38\u306b\u898b\u3048\u308b\u884c\u52d5\u306b\u3082\u7406\u7531\u304c\u3042\u308b<\/strong>\u3001\u3068\u8003\u3048\u308b\u306e\u306f\u30e1\u30f3\u30bf\u30eb\u30d8\u30eb\u30b9\u30b1\u30a2\u306e\u57fa\u672c\u3067\u3059\u3002\u305d\u308c\u306b\u305f\u3068\u3048\u3070\u300c\u4e0d\u7a4f\u300d\u3068\u304b\u300c\u611f\u60c5\u5931\u7981\u300d\u3068\u304b\u30e9\u30d9\u30eb\u3092\u8cbc\u3063\u3066\u5206\u304b\u3063\u305f\u3064\u3082\u308a\u306b\u306a\u308b\u306e\u3067\u306f\u306a\u304f\u3001<strong>\u305d\u306e\u3068\u304d\u306e\u305d\u306e\u4eba\u306a\u308a\u306e\u7406\u7531\u304c\u3042\u308b<\/strong>\uff08<a href=\"#note1\">\u6ce8<\/a>\uff09\u3068\u8003\u3048\u308b\u306e\u304c\u5927\u5207\u3067\u3059\u3002\u305d\u306e\u771f\u9006\u306a\u306e\u304c\u300c\u4e0d\u7a4f\u300d\u306e\u3088\u3046\u306a\u533b\u5b66\u3063\u307d\u3044\u7528\u8a9e\u3092\u4f7f\u3046\u3053\u3068\u3067\u8133\u306e\u554f\u984c\uff08\u539f\u56e0\u304c\u8133\u306b\u3042\u308b\u3068\u3044\u3046\u300c\u9084\u5143\u4e3b\u7fa9\u300d\uff09\u3068\u6c7a\u3081\u3064\u3051\u3066\u3057\u307e\u3046\u3053\u3068\u3067\u3059\u3002\u305d\u306e\u3053\u3068\u3067\u5411\u7cbe\u795e\u85ac\u306e\u4e71\u7528\u3001\u3055\u3089\u306b\u306f\u4eba\u683c\u3042\u308b\u5b58\u5728\u3068\u3044\u3046\u898b\u65b9\u3092\u5fd8\u308c\u308b\u3053\u3068\u3067\u8eab\u4f53\u62d8\u675f\u306a\u3069\u306b\u3064\u306a\u304c\u308a\u5f97\u307e\u3059\u3002<\/p>\n<p><strong>\u305d\u306e\u7406\u7531\u3068\u3057\u3066\u904e\u53bb\u73fe\u5728\u306e\u30c8\u30e9\u30a6\u30de\u4f53\u9a13\u3092\u8003\u3048\u3066\u304a\u304f\u3001\u3068\u3044\u3046\u306e\u304c\u3053\u3053\u3067\u8a00\u308f\u308c\u3066\u3044\u308b\u3053\u3068\u3067\u3059\u3002\u7570\u5e38\u306b\u898b\u3048\u308b\u884c\u52d5\u306f\u7570\u5e38\u306a\u4f53\u9a13\uff08\u30c8\u30e9\u30a6\u30de\u4f53\u9a13\uff09\u306b\u5bfe\u3059\u308b\u6b63\u5e38\u306a\u53cd\u5fdc\u3067\u3042\u308b\u3001\u3068\u8003\u3048\u308b\u306e\u304cTIA\u306e\u57fa\u672c\u3068\u8a00\u3048\u307e\u3059\u3002<\/strong>\u5fc5\u305a\u3057\u3082\u4e00\u3064\u4e00\u3064\u306e\u884c\u52d5\u306e\u7406\u7531\u304c\u7279\u5b9a\u3067\u304d\u308b\u3068\u306f\u9650\u308a\u307e\u305b\u3093\u3002\u305d\u308c\u3067\u3082\u3053\u306e\u3088\u3046\u306b\u8003\u3048\u308b\u3053\u3068\u306f<strong>\u554f\u984c\u3092\u305d\u306e\u4eba\u306e\u300c\u5185\u300d\u3067\u306f\u306a\u304f\u300c\u5916\u300d\u306b\u3042\u308b\u3068\u898b\u308b<\/strong>\u3053\u3068\u306b\u306a\u308a\u307e\u3059\u3002\u3053\u308c\u306f\u6cbb\u7642\u3084\u652f\u63f4\u306b\u5927\u304d\u306a\u5909\u5316\u3092\u3082\u305f\u3089\u3057\u307e\u3059\uff08\u300c<a href=\"http:\/\/chienowa.org\/?p=707\">\u60a3\u8005\u3068\u533b\u5e2b<\/a>\u300d\u3092\u53c2\u7167\uff09\u3002<\/p>\n<div class=\"arconix-toggle-wrap\"><div class=\"arconix-toggle-title toggle-closed\"><i class='fa fa-plus-square'><\/i>\u539f\u6587\u304b\u3089\u5f15\u7528 \u30af\u30ea\u30c3\u30af\u3059\u308b\u3068\u958b\u304d\u307e\u3059<\/div><div class=\"arconix-toggle-content\">\n<blockquote><p>There is an understanding that trauma plays a role in mental and substance use disorders and should be systematically addressed in prevention, treatment, and recovery settings.<\/p><\/blockquote>\n<\/div><\/div>\n<p>\u6b21\u306b\u3001<strong>\u7cbe\u795e\u75be\u60a3\u3068\u85ac\u7269\u3084\u30a2\u30eb\u30b3\u30fc\u30eb\u4e71\u7528\u306b\u30c8\u30e9\u30a6\u30de\u304c\u95a2\u308f\u3063\u3066\u3044\u308b<\/strong>\u3053\u3068\u3001\u3060\u304b\u3089<strong>\u4e88\u9632\u3084\u6cbb\u7642\u3084\u56de\u5fa9\u306e\u5834\u9762\u3067\u4f53\u7cfb\u7684\u306b\u30c8\u30e9\u30a6\u30de\u306b\u53d6\u308a\u7d44\u307e\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044<\/strong>\u3001\u3068\u3044\u3046\u3053\u3068\u3092\u7406\u89e3\u3057\u3066\u304a\u304f\u3079\u304d\u3067\u3059\u3002<\/p>\n<p>\u30a2\u30eb\u30b3\u30fc\u30eb\u4e71\u7528\u306b\u30c8\u30e9\u30a6\u30de\u304c\u95a2\u308f\u3063\u3066\u3044\u308b\u3053\u3068\u306f\u3001\u65e5\u672c\u3067\u306f\u8fd1\u5e74\u306b\u306a\u3063\u3066\u6ce8\u76ee\u3055\u308c\u3064\u3064\u3042\u308a\u307e\u3059\u3002\u79c1\u81ea\u8eab\u306e\u7d4c\u9a13\u3082\u305d\u308c\u3092\u88cf\u4ed8\u3051\u3066\u3044\u307e\u3059\u3002ACE\uff08\u5b50\u3069\u3082\u6642\u4ee3\u306e\u6709\u5bb3\u306a\u4f53\u9a13\uff09\u306e\u5f71\u97ff\u306f\u3082\u3061\u308d\u3093\u3067\u3059\u304c\u3001DV\u88ab\u5bb3\u304c\u304d\u3063\u304b\u3051\u3068\u306a\u3063\u305f\u30b1\u30fc\u30b9\u3082\u8907\u6570\u77e5\u3063\u3066\u3044\u307e\u3059\u3002<\/p>\n<div class=\"arconix-toggle-wrap\"><div class=\"arconix-toggle-title toggle-closed\"><i class='fa fa-plus-square'><\/i>\u539f\u6587\u304b\u3089\u5f15\u7528 \u30af\u30ea\u30c3\u30af\u3059\u308b\u3068\u958b\u304d\u307e\u3059<\/div><div class=\"arconix-toggle-content\">\n<blockquote><p>Similarly, there is a realization that trauma is not confined to the behavioral health specialty service sector, but is integral to other systems (e.g., child welfare, criminal justice, primary health care, peer\u2013run and community organizations) and is often a barrier to effective outcomes in those systems as 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