Both Sides of the Desk: Trauma-Informed Services in the Child Support Program

Transcription

1 Both Sides of the Desk: Trauma-Informed Services in the Child Support Program Rebecca Sharp, MPA, LMSW Katie Morgan, SC IV-D Director

2 Both Sides of the Desk: Trauma-Informed Services in the Child Support Program Childhood trauma can impact all of us. Whether it s the loss of a parent through death or divorce, alcohol or drug use in the family, child abuse, domestic violence or myriad other events, our childhood experiences impact us to a greater degree than previously understood. This is also true of our clients. This session explores the impact trauma can have on the delivery of child support services, what it means to become a Trauma- Informed Agency, and the steps needed to get there.

3 Developing a Trauma-Informed System of Care Learning Objectives What is Trauma Neurobiological responses and long term consequences ACE Study: Unveiling a Public Health Issue Understanding the Power of Resiliency What this means in Child Support How To Become a Trauma Informed Child Support Organization

4 What Is Trauma? Trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically and emotionally harmful or threatening and that has lasting adverse effects on the individual s physical, social, emotional, or spiritual well being. ~ SAMHSA, 2012 Most everyone has been through a stressful event in his or her life. When the event, or series of events, triggers prolonged physical and emotional stress it is called a traumatic experience.

5 Types of Trauma Acute Chronic Complex Historical Secondary Neglect and Traumatic Grief & Loss System Induced Trauma Culture of Poverty

6 A Public Health Policy Crisis We are facing one of the most significant challenges to the future of America s children that we have ever known. Our children are experiencing and witnessing violence on an alarming scale. Advances in neuroscience and child development have taught us that the trauma children experience when they are exposed to physical, sexual, and emotional violence harms their ability to mature cognitively and emotionally, and it scars them physically and emotionally well into their adult lives. We pay astronomical costs to the healthcare, child welfare, justice, and other systems because we have not yet done what we know works to prevent and treat childhood trauma. ~ US Attorney General Task Force on Defending Childhood, 2012

7 What We All Need All human beings need secure, loving connections to thrive; especially when they are children.

8 Our early experiences impact EVERY relationship for the rest of our lives

9 If our needs are not met when we are young, or if we experience trauma, the results impact every relationship we have forever.

10 Survival Mode Traumatic events trigger our survival instincts and produce intense physical effects pounding heart, rapid breathing, trembling, tunnel vision, dizziness, loss of bladder or bowel control

11 Trauma Triggers A Trauma Trigger is a reminder of a past traumatizing event. Encountering such triggers may cause us to feel uneasy, depressed, anxious, afraid, short-tempered. Sometimes we know why we are feeling a certain way and other times we aren t sure why Recognizing when we are being triggered is an important part of building the skills to manage our trauma responses. Keep in mind that survivors responses to seemingly neutral events and interactions with people may reflect a trauma response.

12 Survival Instinct

13 Body s Physical Response to Stress BRAIN RELEASES ACTH HORMONES, CORTIZOL AND ADRENALINE Energy to Muscles Liver produces Glucose

14 Some stress is good repeated stress is toxic

15 Children who experience early childhood trauma do not just get over it.

16 National Survey of Children s Exposure to Violence (N=4549) American Children and Youth in the Past Year 60.6 % experienced or witnessed at least one violent victimization in the past year % of American children and youth assaulted in the past year % suffered child maltreatment by a caregiver. 6.1 % victimized sexually % witnessed a violent act. 9.8 % witnessed a family member assault another % experienced 2 or more direct victimizations.

17 Psychological and Behavioral Impact of Childhood Victimization Abuse and victimization in childhood correlated with: Anxiety disorders (PTSD, social phobia, generalized anxiety disorder) Affective disorders (major depression, mood disorders) Conduct disorders, Oppositional Defiant disorder, Impulse control disorder Sexual disorders Substance use/abuse/dependence (drug, alcohol, tobacco) Delinquency and criminal behavior Violent behavior (peer aggression, dating violence, spouse/partner violence) Social Relationship Difficulties Other problems (future victimization, self-esteem, guilt, shame, self-blame, academic performance, occupational achievement, neurobiological development, eating disorders) Comorbid problems

18 Do You Know Your ACE Score?

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31 Why Are ACEs Significant? ACEs are common nearly two-thirds (64%) of adults have at least one. ACEs generally don t occur alone.if you have one, there s an 87% chance that you have two or more. The more ACEs you have, the greater the risk for chronic disease, mental illness, being a victim or perpetrator of violence, to have more marriages, more broken bones, more prescriptions, more depression and more autoimmune diseases. People with an ACE score of 4 are twice as likely to be smokers and seven times more likely to be alcoholic; and increases the risk of emphysema or chronic bronchitis by nearly 400 percent, and suicide by 1200 percent. People with an ACE score of 6 or higher are at risk of their lifespan being shortened by 20 yrs. ACEs are responsible for a big chunk of workplace absenteeism, and for costs in health care, emergency response, mental health, criminal justice, and contributes to most of our major chronic health, mental health, economic health and social health issues.

32 ACE Pyramid

33 Resiliency Positive Youth Development Model COMPETENCE CONFIDENCE CONNECTION CHARACTER CONTRIBUTION COPING CONTROL THE 7 Cs: THE ESSENTIAL BUILDING BLOCKS OF RESILIENCE

34 What does this mean in the Child Support Community?

35 Responding Today with Yesterday s Fear

36 An Undesirable Impact Shaming, blaming, punishing & disconnecting people for the normal, natural responses to what has happened to them does not make them more responsible or accountable, it harms them further and makes them less capable of meeting requirements.

37 View Behaviors through a TRAUMA LENS Moving from: What s wrong with you? To: What happened to you? AND how do I do things DIFFERENTLY because of what s happened to you?

38 Taking a Trauma Informed Approach Realize the widespread impact of trauma Seek to actively resist retraumatization Recognize the signs and symptoms of trauma in clients, families, staff and others Integrate knowledge about trauma into policies, procedures, and practice

39 SAMSA S 6 Key Principles for a Trauma Informed Approach Safety Trustworthiness Peer support Collaboration and mutuality Empowerment, voice and choice Cultural, historical, and gender issues

40 It means that we Establish a working relationship with the family so that we begin to understand and respect their history and understand their triggers Create a safe environment for custodial parents, non-custodial parents AND staff Focus on child and family engagement, empowerment and collaboration. Include mental health community and other referrals Include ALL staff in training on the impacts of trauma

41 BECOMING A TRAUMA INFORMED ORGANIZATION GETTING STARTED Child Welfare Trauma Training Toolkit (2008, 2013)

42 BECOMING A TRAUMA INFORMED ORGANIZATION Agency Self-Assessment The Self-Assessment is organized into five main domains or areas of programming to be examined: Supporting Staff Development Creating a Safe and Supportive Environment Assessing and Planning Services Involving Consumers Adapting Policies Trauma-Informed Organizational Toolkit Adopted from the National Center on Family Homelessness Trauma- Informed Organizational Self-Assessment and Creating Cultures of Trauma- Informed Care: A Self Assessment and Planning Protocol by Roger D. Fallot, Ph.D. & Maxine Harris, Ph.D.

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