Developing A Trauma Informed Community Jean West LCSW CTC-S CT What is trauma? 6/28/13. Experiences which can cause trauma

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1 Developing A Trauma Informed Community Jean West LCSW CTC-S CT jean.west@sjsd.k12.mo.us What is trauma? A traumatic event is an overwhelming experience that is often sudden and unexpected. The experience usually involves some kind of threat to self or a loved one and leads to feelings of intense fear and helplessness. Experiences which can cause trauma Physical and/or sexual abuse Domestic violence Living with substance abusing parents Witnessing parental homicide Homelessness Burns/other serious accidents Car fatalities Divorce Natural disasters 1

2 How does Trauma Impact Behavior? Traumas Effect on Behavior Hypervigilance Difficulty sleeping Easily startled Clinging Nightmares Disobedience Impaired social skills Anger /rage Can t self sooth or modulate emotions Depression Attention problems Impulsivity Aggression Fearful Risk taking Panic attacks Hypersensitive to touch, movement, some sounds and smells How does Trauma Impact Learning? 2

3 Traumas Effect on Learning In the arousal (anxious) state it becomes difficult to process information, follow directions, recall information, and focus Physician s office Poor problem solving, attention, disorganized Often only hear half of the words spoken by their teachers Cognitively will generally be far behind their peers, children can often learn at three times the rate compared to when engulfed in trying to survive Trauma-Informed Care Trauma-informed care is an approach to engaging people with histories of trauma that recognizes the presence of trauma symptoms and acknowledges the role that trauma has played in their lives. The National Center for Trauma Informed Care Trauma Informed Practice Trauma recovery involves not only focused intervention, but also the interrelationship of the individual with others within a community These environments may either help or impede a child s progress toward trauma integration Residential care, hospital, shelter, school etc.steele and Malchiodi

4 Community Collaboration Who needs to come on board? How do we Get Them There? Trauma Champions Where are they in your community? Is it you???? 4

5 Change Trauma-Informed Environments Apply specific processes and criteria to create and/ or change an environment so that its members can engage the kind of relationships, practices, and processes that do not inadvertently traumatize children and or retraumatize previously exposed children. Steele and Malchiodi 2012 Five Key Components 1. Establish a core set of values Address the developmental needs of children Who they are What they stand for What they live by 5

6 Values What are the values in your agency? Policy and Procedures Are they driven by our beliefs as an organization or what we have always done? What are our core beliefs? How does that play out when we are working with our consumers/clients? Examples Beliefs 2. Establish sustainable trauma-informed beliefs Align with core values Drive behaviors and practices 6

7 Practices Driven by Beliefs Starr Commonwealth : There is no such thing as a bad child This one belief dismisses the belief that troubled children are pathological, but instead simply not given the environment needed for their strengths to emerge Education 3. Educate organizations to provide training All staff need to know their role in trauma-informed care Appropriate interventions and why Why is VERY IMPORTANT Accountability 4.Establish measures that show us how we are doing How many times have we said this to our clients? Promote sustainability 7

8 Specific Process 5. Identify a specific process for identifying and initiating trauma-informed values and beliefs Sustaining integrity How do we keep this going? How do we know when we are off track? Where do we Start? You may want to pick a specific organization, social issue, or sub-set The Homeless 8

9 How large of a problem do we have? According to the National Coalition for the Homeless, 1.2 million children are homeless on any given night. Supporting this figure are estimates from the U.S. Department of Education that report almost 400,000 homeless children were served by the nation's public schools last year. SJSD stats Impact of Homelessness on Children Every day, homeless children are confronted with stressful, often traumatic events. 74% of homeless children worry they will have no place to live. 58% worry they will have no place to sleep. 87% worry that something bad will happen to their family. (Impact on education, trauma) Within a single year: Impact cont 97% of homeless children move, many up to three times. More than 30% are evicted from their housing. 22% are separated from their family to be put in foster care or sent to live with a relative. Almost 25% have witnessed acts of violence within their family. 9

10 Mental Health The constant barrage of stressful and traumatic experiences has profound effects on the cognitive and emotional development of homeless children. Homeless babies show significantly slower development than other children do. Homeless children between 6 and 17 years struggle with very high rates of mental health problems. Teens Homeless youth exhibit psychiatric disorders at a rate six times greater than the general youth population, with between 66 and 89 percent of homeless youth having symptoms of one or more disorders. Whitbeck, 2009 The Emotional Impact More then one-fifth of homeless preschoolers have emotional problems serious enough to require professional care, but less then one-third receive any treatment. Homeless children have twice the rate of learning disabilities and three times the rate of emotional and behavioral problems as nonhomeless children. Half of school-age homeless children experience anxiety, depression, or withdrawal compared to 18% of nonhomeless children. By the time homeless children are eight years old, one in three has a major mental disorder. NCTSN

11 Homeless Fathers Although 70% of fathers of homeless children are in touch with their children, most do not live with the family. The downward spiral into homelessness for a child is often accelerated if a father loses his job, becomes injured or ill, has a bout with alcohol or drugs, or is involved with the criminal justice system. 50% of fathers are unemployed. 43% have problems with drugs or alcohol. 31% have physical or mental health problems. 32% are in jail or on probation. Homeless Mothers Violence The frequency of violence in the lives of homeless mothers is staggering. 63% have been violently abused by an intimate male partner. 27% have required medical treatment because of violence by an intimate male partner. 25% have been physically or sexually assaulted during adulthood by someone other than an intimate partner. 66% were violently abused by a childhood caretaker or other adult in the household before reaching % were sexually molested as children. 11

12 Trauma and Homelessness Cont Homelessness results in a loss of community, routines, possessions, privacy, and security. According to The National Child Traumatic Stress Network, more than 90% of sheltered and low-income mothers have experienced physical and sexual assault over their lifespan. The experience of homelessness puts families in situations where they are at greater risk of additional traumatic experiences such as assault, witnessing violence, or abrupt separation. The stresses associated with homelessness can exacerbate other trauma-related difficulties and interfere with recovery due to ongoing traumatic reminders and challenges. NCTSN 2005 Trauma and Homelessness Trauma- physical, sexual, and emotional is both a cause and a consequence of homelessness. HCH 1999 Trauma and Homelessness Cont Trauma is THE predominant mental health issue for homeless mothers. Research confirms that the strongest predictor of emotional and behavioral problems in poor and homeless children is their mother s level of emotional distress. HCH 2003 (resiliency research with TLC) Emotional help is needed for both the parents and their children in order to be most effective. 12

13 What Does it Mean for your Agency to be Trauma Informed? Safety Structure Becoming a witness We must be aware of how our own experiences effect our ability to help Becoming Trauma Informed cont Becoming trauma-informed is a process that involves striving towards a new way of understanding people and providing services and supports. This process involves a gradual integration of trauma concepts and trauma sensitive responses into daily practice. Do we do this? 13

14 Becoming Trauma Informed Understanding Trauma and Its Impact: Understanding traumatic stress and how it impacts people and recognizing that many behaviors and responses that maybe seem ineffective and unhealthy in the present, represent adaptive responses to past traumatic experiences. The Importance of Safety People are not successful in environments where they do not feel physically and emotionally safe, heard, and respected. For people who have experienced trauma, issues of safety become even more prominent. Promoting Safety: Safety Establishing a safe physical and emotional environment where basic needs are met Safety measures are in place Provider responses are consistent, predictable, and respectful 14

15 How do we help? One of the crucial ways children are able to heal is with support from caregivers to make them feel safe, secure, and protected. The level of support a child receives from a caregiver is the most significant factor in how well a child fares after a traumatic event. The National Center on Family Homelessness 2007 Safety continued Creating Consumer Crisis Prevention Plans A written, individualized consumer self-care or crisis-prevention plan should include the following: A list of situations that the consumer finds stressful or overwhelming and remind him/ her of past traumatic experience (i.e., triggers). Ways that the consumer shows that he/she is stressed or overwhelmed (e.g. types of behaviors, ways of responding, etc.). Staff responses that are helpful when the consumer is feeling upset or overwhelmed. Staff responses that are not helpful when the consumer is feeling upset or overwhelmed. A list of people to go to for support. A list of situations that the consumer finds stressful or overwhelming and remind him/ her of past trauma. Avoid Secondary Victimization or Wounding Secondary victimization or wounding occurs when the people and organizations you turn to for help respond in subtle ways that cause you additional pain. Denial and disbelief Discounting and minimizing Blaming you Treating you as defective 15

16 Importance of Assessment Process How does your agency assess for possible trauma exposure? Are specific, similar questions being asked? What more needs to be done? Is there any consistency in assessment throughout your community? Work groups Learning Circles Trainings Sustainability 16

17 Relationships Healing Happens in Relationships: Believing that establishing safe, authentic and positive relationships can be corrective and restorative to survivors of trauma. Hope for the Future Recovery is Possible: Understanding that recovery is possible for everyone regardless of how vulnerable they may appear instilling hope by providing opportunities for consumer and former consumer involvement at all levels of the system facilitating peer support focusing on strength and resiliency establishing future-oriented goals 17

18 The first task of recovery is to establish the survivor s safety. This task takes precedence over all others, for no other therapeutic work can possibly succeed if safety has not been adequately secured. Herman 1992 Resources Cowan, Beryl Ann, "Trauma exposure and behavioral outcomes in sheltered homeless children: The moderating role of perceived social support" (2007). Psychology Dissertations. Paper HCH Health Care for the homeless Clinician s network. Trauma and Homelessness.(1999) Vol.3, No.3 HCH Health Care for the homeless clinician s network. Homelessness and family trauma: The Case for early intervention. (2003) Vol. 7, No. 2 NCTSN The National Child Traumatic Stress Network. Facts on Trauma and homeless children. (2005) Steele,W. and Malchiodo, C. Trauma-Informed Practices With Children and Adolescents. Routledge Les Whitbeck, Mental Health and Emerging Adulthood Among Homeless Young People (New York: Psychology Press, 2009) 54,

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