Trauma Informed Care for Youth & The VCC Trauma Recovery Program for Youth

Transcription

1 Trauma Informed Care for Youth & The VCC Trauma Recovery Program for Youth 1

2 A response that involves intense fear, horror and helplessness; extreme stress that overwhelms the person s capacity to cope (American Psychological Association, 2000) 2

3 Threatens the life or physical integrity of a child or someone important to that child Causes an overwhelming sense of terror, helplessness and horror Produces intense physical effects such as a pounding heart, rapid breathing, trembling, dizziness or loss of bladder or bowel control 3

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5 Remember... It is an individual s experience of the event, not necessarily the event itself that is traumatizing. 5

6 Acute Trauma A single traumatic event that is limited in time. Chronic Trauma The experience of multiple traumatic events. Vicarious Trauma Complex Trauma Both exposure to chronic trauma and the impact of that exposure on an individual. System Induced Trauma The traumatic removal from home, admission to a detention/residential facility or multiple placements within a short time. 6

7 Acute Trauma A single traumatic event that is limited in time. 7

8 Chronic Trauma The experience of multiple traumatic events. 8

9 Complex Trauma Both exposure to chronic trauma and the impact of that exposure on an individual. 9

10 System Induced Trauma The traumatic removal from home, admission to a detention/residential facility or multiple placements within a short time. 10

11 Vicarious Trauma 11

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13 Trauma Survivor s Experience 13

14 Seeing, feeling, hearing, smelling something that reminds us of past trauma activates an alarm system.... The response is as if there is a current danger. The thinking brain automatically shuts off in the face of triggers. Past and present danger becomes confused. 14

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16 Prevalence of Trauma - Child Welfare and Family Safety In 2008, nearly 750,000 children in the U.S. were maltreated. Over 26%, of those children were under the age of 3 and 12.3% being under 1 year of age. (US Department of Health and Human Services, 2010) On average, 35% of homes with intimate partner violence victims have children under 12 living in the home. (Catalano, 2007) 16

17 Prevalence of Trauma - Juvenile and Criminal Justice 92% of incarcerated girls reported a history of sexual, physical and/or emotional abuse. (Acoca & Dedel, 1998) In an isolated jail study of 100 men, 59% reported childhood sexual abuse prior to puberty. (Johnson et al., 2006) 43 57% of men and women in federal and state prisons have reported physical or sexual abuse histories. (Harlow et al., 1999) 17

18 Prevalence of Trauma - Adolescents and Substance Abuse Adolescents who have experienced physical abuse or sexual abuse/assault are three (3) times more likely to report past or current substance abuse. Up to 59% of young people with PTSD subsequently develop substance abuse problems. In as many as 66% of adolescents substance use precedes the trauma. 18

19 Over 90% of juvenile detainees reported having experienced at least one traumatic incident. PTSD among youth in the juvenile justice system is similar to youth in the mental health and substance abuse systems and up to 8 times higher than youth in the general population. 19

20 Although most youth who experience psychological trauma recover are healthy, as many as 50% of the youth in the juvenile justice system experience chronic health and psychological impairments related to trauma. Dependent and Delinquent Youth??? 20

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22 Trauma Informed Systems of Care 1. Recognize the impact of trauma on those we serve and staff who deliver services 2. Recognize the need to complete comprehensive assessments on trauma histories and symptoms 3. Recognize and identify culture and practices that are retraumatizing 22

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24 Effects can be: Impact of Trauma Neurological: Changes in the brain Biological: Physical Changes Psychological: Changes in how we think and/or perceive Social: Changes in how we behave 24

25 Impact of Trauma All Ages Frequent memories, triggers and/or flashbacks Sleep disturbances Psychological and physiological problems Acting or feeling like the experience is happening again Develop repeated physical or emotional symptoms when reminded of the event SYMPTOMS OF TRAUMA ARE FREQENTLY NOT RECOGNIZED and usually MISDIAGNOSED. 25

26 Impact of Trauma Children For Children - pick a D any D at all!!! ADD, ADHD, ODD, OCD, LD, PDD, DBD when most likely PTSD 26

27 Impact of Trauma - Children 27

28 Foster Care Special Population with Unmet Needs Flight, Fight & Fear Responses Sensory Problems Difficulty with Transition Times and need Previews 28

29 Impact of Trauma Adolescents Self-conscious about their emotional responses to the event Feelings of fear, vulnerability, and concern over being labeled abnormal or different Withdraw from family and friends Feelings of shame and guilt Fantasies about revenge and retribution May foster a radical shift in the way they think about the world Engage in self-destructive or accident-prone behaviors 29

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32 VCC-TRP Referrals Between the ages of 4-18 With emotional and behavioral difficulties associated with abuse, violence and trauma Who may have experienced one or multiple episodes of trauma With parents or caregivers willing to participate in treatment With at least a Full Scale IQ Score of 70 Amenable to outpatient treatment 32

33 VCC-TRP Services Specialized Individual & Family Therapy Specialized Group Therapy Parent Training/Education Trauma Based Mental Health Assessment Specialized Case Management Psychological Evaluations Low Level Biofeedback and Pet Therapy 33

34 All therapy services are provided by Licensed Mental Health Professionals All have been trained in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) Many VCC Therapists have been providing Trauma Related Assessments and Therapy services for over 10 years and offer a range of services dedicated to helping trauma survivors 34

35 VCC Trauma Recovery Program (TRP) Treatment for children and adolescents who have experienced various forms of trauma including neglect, exposure to domestic violence as well as physical, emotional and sexual abuse. Circuits 3 & 8 (Currently) Trauma-Focused Cognitive Behavioral Therapy (TF- CBT) Model 35

36 1. Trauma Exposure What specific traumas have occurred at what ages/stages, and in what circumstances? 2. Traumatic Stress Symptoms What specific PTSD or associated traumatic stress reactions or trauma-exacerbated symptoms are interfering with a youth s ability to think clearly and demonstrate healthy choices and positive growth? 36

37 Don t ever take a fence down until you know why it was put up. Robert Frost 37

38 Treatment results in improvements in symptoms related to Post-Traumatic Stress Disorder (PTSD) as well as depression, anxiety, behavior problems, sexualized behaviors, trauma-related shame, interpersonal trust, and social competence. 38

39 Most children show significant reductions in PTSD symptoms within sessions. The parental/caregiver component of treatment increases the positive effects of treatment for children by improving parents own levels of depression, emotional distress about their children s abuse, support of the child, and parenting practices. 39

40 Most children show significant reductions in PTSD symptoms within sessions. The parental component of treatment increases the positive effects of treatment for children by improving parents own levels of depression, emotional distress about their children s abuse, support of the child, and parenting practices. 40

41 Education about the impact of trauma Identifying and coping with a range of emotions Developing personalized stress management skills Teaching how to recognize the connections between thoughts, feelings and behaviors related to trauma 41

42 Encouraging children to share their traumatic experiences either verbally, in a written narrative Helping children and caregivers talk with each other about the traumatic experiences Modifying inaccurate or unhelpful traumarelated thoughts 42

43 Developing personal safety skills Helping parents develop skills for optimizing their children's emotional and behavioral adjustment and long-term safety 43

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45 Gainesville Main Office Trenton Live Oak Lake City Macclenny Starke Orange Park 45

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