PROMOTING A TRAUMA INFORMED SYSTEM OF CARE: PSYCHOEDUCATIONAL ACTIVITIES FOR SCHOOL-AGED CHILDREN. Megan Plagman, LMSW, MPH & Meghan Graham, LMSW

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1 PROMOTING A TRAUMA INFORMED SYSTEM OF CARE: PSYCHOEDUCATIONAL ACTIVITIES FOR SCHOOL-AGED CHILDREN. Megan Plagman, LMSW, MPH & Meghan Graham, LMSW

2 WHAT IS TRAUMA? Severe neglect, loss, and/or witnessing of violence, terrorism, and disasters -SAMHSA

3 WHO DOES TRAUMA IMPACT? SAMHSA reports that 90% of the population has been impacted by a trauma and that most have been exposed to multiple traumas. Costello, Erkanli, Fairbank, and Angold (2002) estimate 25% of children and adolescents in the community experience at least one potentially traumatic event during their lifetime.

4 COMMON RESPONSES TO TRAUMA Fear Hopelessness Self Blame Self Harming Behaviors Addiction Anxiety Anger Depression Stress that inhibits effective coping

5 IMPACT OF TRAUMA ON CHILDREN Mental Heath Concerns Anger Anxiety Depression Self-harming behaviors Poor Self-care Increased risk for developing psychiatric disorders Increased Problems at School Grades may decline Behavior Problems Inattention Problems in Peer Relationships Increase in high risk behaviors

6 IMPACT OF TRAUMA ON CHILDREN Neurological Responses 2007 longitudinal study of children in western North Carolina showed children exposed to trauma had almost double the rates of psychiatric disorders than those not exposed to trauma during the study period. How a child s brain responds to trauma can alter its developmental trajectory. Alterations can lead to emotional, behavioral, and cognitive difficulties.

7 PTSD Exposure to an extreme trauma. Feelings of fear, helplessness, or horror. Persistent reexperiencing of the traumatic event. Avoiding stimuli associated with the trauma. Approximately 8% of the adult population in America suffers from PTSD. Can occur at any age, including early childhood. Symptoms can appear as early as 3 months following the traumatic event.

8 WHAT IS A TRAUMA INFORMED SYSTEM OF CARE? NCTSN defines as a system in which all parties involved recognize and respond to the impact of traumatic stress on children, caregivers, and service providers. Using culturally sensitive, evidence-informed and evidence-based practices. Ensures resources on trauma available to all branches of the system. Identify and support resiliency factors in children and families impacted by or vulnerable to trauma.

9 WHAT IS A TRAUMA INFORMED SYSTEM OF CARE? Emphasis on continuity of care across services. Maintains a supportive work environment that recognizes and treats secondary traumatic stress. Enhances the resiliency of child care staff.

10 WHY IS HAVING A TRAUMA-INFORMED SYSTEM OF CARE IMPORTANT? Trauma can impact all areas of the survivor s life. Children affected by trauma are more likely to seek services or be referred for services in a health care or educational setting.

11 MERCY COMMUNITY HOPE PROJECT Established in 2010 following the Deepwater Horizon Oil Spill. Reports showed that that nearly 60% of the 925 coastal LA residents were impacted by the spill. 40% reported direct exposure. One in five households reported a decrease in income. Over 25% reported that they may have to relocate due to spill.

12 HOW DID THE OIL SPILL IMPACT CHILDREN? One-third of parents reported that their children had experienced either physical symptoms or mental health distress as a consequence of the oil spill.

13 MCHP S AIM To reduce the symptoms of trauma associated with the oil spill while reinforcing resiliency and positive coping mechanisms among the coastal residents.

14 THE INTERVENTION SKILLS FOR PSYCHOLOGICAL RECOVERY AIM OBJECTIVES To protect the mental health of survivors. Enhance survivor s ability to address needs and concerns. Teach skills to promote recovery. Prevent maladaptive behaviors Identify adaptive behaviors. Measurable increases in psycho-social functioning. Participants will learn a set of empirically-based skills to help cope more effectively. Problem-solving Positive Activity Scheduling Managing Reactions Helpful Thinking Building Healthy Social Connections.

15 MCHP FINDINGS (OAKLAWN JR. HIGH)

16 #1 SYMPTOM ANGER Pre: 50% of the students at Oaklawn Jr. High reported feeling angry due to a traumatic event. Post: 40% of the students reported still having feelings of anger due to a traumatic event.

17 HOW WELL DID THEY COPE? Pre Intervention Post Intervention No coping skills utilized Avoidant and Distracting behaviors Stay quiet about bad things that happen Focus on good things in life Talk to peers Come up with answers to problems. Change upsetting thoughts Talk to Supportive People Think about the good things in life.

18 THREE MONTH FOLLOW-UP Utilized Relaxation Skills Avoidant Behaviors Self Blaming Behaviors Higher Indication of Changing Negative Thoughts Talked to Someone about Problems

19 MCHP FINDINGS (EINSTEIN CHARTER SCHOOL)

20 AGAIN #1 SYMPTOM ANGER

21 HOW WELL DID ECS COPE? Pre Intervention Avoidant Behaviors Self blaming Talk to others about problems Stay quiet about problems Try to forget Try to fix Problems Try to see good side of things Post Intervention Try to see the good side of things Some self-blaming Some Avoidant Try to fix problems Stay Alone Come up with different solutions Positive self-talk Notice good things in life.

22 MCHP SUCCESS MCHP directly served approximately 620 children in MCHP collected research consents and data on approximately 400 of those children. MCHP is currently serving approximately children across three parishes. MCHP recently conducted follow-ups in MMS and LMS and had 36 children attend the followup session. In the summer before concluding our current grant, we are hoping to have 10 groups with 6-10 children in each group.

23 MCHP SUCCESS STORIES

24 REFERENCES Becker-Blease, K. A., Turner, H.A., & Finkelhor, D. (2010). Disaster, victimization, and children s mental health, Child Development, 81 (4), Berkowitz, S., Bryant, R., Brymer, M., Hamblen, J., Jacobs, A., Layne, C., Macy, R., Osofsky, H., Pynoos, R., Ruzek, J., Steinberg, A., Vernberg, E., & Watson, P. (2010). The National Child Center for PTSD & the National Child and Traumatic Stress Network, Skills for Psychological Recovery: Field Operations Guide. Copeland, W. E., Keeler, G., Angold, A., Costello, J. (2007). Traumatic events and posstraumatic stress in childhood, Arch Gen Psychiatry, 64, Costello, E., Erkanli, A., Fairbank, J. A., & Angold, A. (2002). The prevalence of potentially traumatic events in childhood and adolescence. Journal of Traumatic Stress, 15, DeBellis, M. D. (2005) The psychobiology of neglect, Child Maltreatment, 10, Jones, D. A., Trudinger, P., & Crawford, M. (2004). Intelligence and achievement of children referred following sexual abuse, Journal of Pediatric child Health, 40, Kendall-Tacket, K. A., Williams, L.M., & Finkelhor, D. (1993). Impact of sexual abuse on children: A review and synthesis of recent empirical studies, Psychology Bulletin, 113,

25 REFERENCES Ko, S. J., Kassam-Adams, N., Wilson, C., Ford, J. D., Berkowitz, S. J., Wong, M., Brymer, M. J., & Layne, C. M. (2008). Creating trauma-informed systems: Child welfare, education, first responders, health care, juvenile justice, Professional Psychology: Research and Practice, 39 (4), National Child Traumatic Stress Network. (2013). Creating trauma-informed systems. Retrieved from Porter, C., Lawson, J. S., & Bigler, E. D. (2005). Neurobehavioral sequelae of child sexual abuse. Child Neuropsychology, 11, Substance Abuse and Mental Health Services Administration. (2013). Trauma informed care and trauma informed services. Retrieved from Wilson, K. R., Hansen, D. J., & Li, M. (2011). The traumatic stress response in child maltreatment and resultant neuropsycholoical effects, Aggression and Violent Behavior, 16,