Trauma Informed Care: What Educators Need to Know · 2018. 8. 2. · Registry of Evidence‐based...

442016

Trauma Informed Care What Educators Need to Know

2016 PA PBS Implementers Forum May 6 2016

Sherry Peters MSW ACSW Senior Policy Associate Georgetown University Center for Child and Human Development

copy 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDRENrsquoS MENTAL HEALTH GEORGETOWN UNIVERSITY

bull Trauma is pervasive bull Trauma affects a studentrsquos ability to learn

bull ldquoSystemsrdquo sometimes re‐traumatize bull ldquoTrauma‐Informedrdquo environments can help ‐ including addressing ldquosecondary traumatic stressrdquo bull Many available resources for tiers 1 2 and 3

Essential

Takeaway Concepts

Agenda for Today

1

442016

What is Trauma

How do you define trauma

What may cause trauma


Individual trauma results from

bull an event series of events or set of circumstances that is

bull experienced as physically or emotionally harmful or life threatening and that has

bull lasting adverse effects on the individualrsquos functioning and mental physical social emotional or spiritual well‐being

SAMHSArsquos Concept of Trauma and Guidance for a Trauma‐Informed Approach 2014 httpstoresamhsagovproductSMA14‐4884from=carouselampposition=4ampdate=09032014

copy 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDRENrsquoS MENTAL HEALTH GEORGETOWN UNIVERSITY 4

2

442016

A program organization or system that is trauma‐informed

bull Realizes the widespread impact of trauma

bull Recognizes the signs and symptoms of trauma in both people we serve and staff

bull Responds with policies procedures and practices

bull Resists re‐traumatization SAMHSArsquos Concept of Trauma and Guidance for a Trauma‐Informed Approach 2014

httpstoresamhsagovproductSMA14‐4884from=carouselampposition=4ampdate=09032014


Trauma Informed Principles

Safety Physical and Emotional Trustworthiness amp Transparency Empowerment Voice amp Choice Collaboration and Mutuality Cultural Historical and Gender Issues Peer Support



3

442016


One of the largest investigations ever conducted to assess associations between childhood

maltreatment and later‐life health and well‐being

Collaboration between the Centers for Disease Control and Prevention and Kaiser Permanentes

Health Appraisal Clinic in San Diego

httpwwwcdcgovaceprevalencehtmACED

Adverse Childhood Experience (ACE) Study

ACE Study Continued

bull Initial phase 1995 to 1997

bull More than 17000 participants ndash completed a standardized physical examination and completed a confidential survey that contained questions about childhood maltreatment and family dysfunction as well as items detailing their current health status and behaviors

bull No further participants were enrolled but medical status of the baseline participants tracked over time



4

442016

10 Adverse Childhood Experiences Studied

bull Household Situations bull Childhood abuse ndash Parental separation or

ndash Emotional divorce

ndash Household substance abuse ndash Physical ndash Household mental illness

ndash Sexual ndash Mother treated violently

bull Neglect ndash Incarcerated household member

ndash Emotional

ndash Physical



Adverse Childhood Experiences are Common

Retrieved from httpacestoohighcomgot‐your‐ace‐score


5

442016


ADVERSE CHILDHOOD EXPERIENCES

11

httpwwwcdcgovviolencepreventionacestudy


Antidepressant Prescriptions

12


6

442016


Suicide Attempts

13



Adult Alcoholism

14


7

442016


Teen Sexual Behaviors

15


Consequences of Lifetime Exposure to Violence Retrieved from httpacestoohighcomgot‐your‐ace‐score

bullAlcoholism and alcohol abuse bullChronic obstructive pulmonary disease (COPD) bullDepression bullFetal death bullHealth‐related quality of life bullIllicit drug use bullIschemic heart disease (IHD) bullLiver disease bullRisk for intimate partner violence bullMultiple sexual partners bullSexually transmitted diseases (STDs) bullSmoking bullSuicide attempts bullUnintended pregnancies bullEarly initiation of smoking bullEarly initiation of sexual activity bullAdolescent pregnancy


8

442016

Finding your ACE Score

What is your total ACE Score Worksheet to calculate ACE Score

__ 0 __ 6

__ 1 __ 7

__ 2 __ 8

__ 3 __ 9

__ 4 __ 10

__ 5



Affects on the Brain and Impact on Learning

Video Clips


9

442016

Impact on the Brain Long‐Term Impact of Toxic Stress

bull Children experiencing toxic stress may ndash Be easily overwhelmed by minor stressors such as a change in their schedule or routine

ndash Have difficulty soothing or calming themselves

ndash Have difficulty with focusing and paying attention

ndash Be anxious unable to settle down

ndash Exhibit Bullying and other aggressive behaviors

ndash Experience hyperarousal that causes that to overreact to nonthreatening triggers

ndash Exhibit dissociation from the traumatic event in which the child shuts down emotionally

ndash Exhibit disruptions in emotional attachment


Resilience

Fortunately brains and lives are somewhat plastic The appropriate

integration of resilience factors born out of ACE concepts mdash such as asking for help developing trusting relationships forming a positive attitude listening to feelings mdash can help people improve their

lives


10

442016

What Is Your Resilience Score

bull Developed by the early childhood service providers pediatricians psychologists and health advocates of Southern Kennebec Healthy Start Augusta Maine in 2006 and updated in February 2013

bull Mark Rains and Kate McClinn created the 14 statements with suggestions from members of the group

bull Scoring system was modeled after the ACE Study questions

bull Content based on research studies over 40 years including Emmy Werner

bull Purpose is limited to parenting education ‐ not developed for research


Factors that contribute to resilience include

bull Close relationships with family and friends

bull A positive view of yourself and confidence in your strengths and abilities

bull The ability to manage strong feelings and impulses

bull Good problem‐solving and communication skills

bull Feeling in control

bull Seeking help and resources

bull Seeing yourself as resilient (rather than as a victim)

bull Coping with stress in healthy ways and avoiding harmful coping strategies such as substance abuse

bull Helping others

bull Finding positive meaning in your life despite difficult or traumatic events


httpwwwpbsorgthisemotionallifetopicresiliencewhat-resilience

11

442016


Resilience Trumps ACEs


httpgucchdtacentergeorgetowneduTraumaInformedCareModule1html

Introductory Video to Module 1

12

442016


In what parts of this story do you see opportunities for educators to have responded differently

What strategies currently exist in your schools that would have helped Henry at an earlier stage

Henryrsquos Story Reflection Questions

25


9 Introductory Videos

8 Modules

Partnership with JBS International

LINKS TO THE TOOL httpgucchdtacentergeorgetowneduTraumaInformedCare

or httptraumajbsinternationalcomtraumatool

13

Youth Mental

copy 2014 NATIONAL T

442016

ECHNICAL ASSISTANCE CENTER FOR CHILDRENrsquoS MENTAL HEALTH GEORGETOWN UNIVERSITY

5 Issue Briefs

7 Sets of Annotated Resources

27 Content Videos (11 hours total)

Example of video from Module 1 Understanding the Impact of Trauma

Other Summary Documents

Multi‐Tiered Approach to Trauma‐Informed Care in Schools


eg CBITS or SSET

egTF‐CBT

eg screening attention to transitions calming activities

PAX

Youth Mental Health First Aid

14

442016

Examples of Resources for All Students bull Trauma Sensitive Schools The Trauma and Learning Policy Initiativersquos (TLPI) mission is to ensure that children traumatized by exposure to family violence and other adverse childhood experiences succeed in school As part of this effort TLPI published Helping Traumatized Children Learn (HTCL) which introduces the Flexible Framework a tool organized according to six core operational functions of schools that can help any school create a trauma sensitive learning environment for all children The publication consists of two volumes Volume 1) A Report and Policy Agenda and Volume 2) Creating and Advocating for Trauma‐Sensitive Schools

bull PAX Good Behavior Gamereg (PAX for short) PAX is officially included on the US National Registry of Evidence‐based Programs and Practices It teaches children to self‐regulate to work together for common goals and to focus on a positive future they co‐create with others These are core cognitive emotional and behavioral skills required for peaceful productive healthy and happy lives PAX is not a classroom or behavior management program yet has the benefit of making any classroom easier to manage PAX reduces teacher and staff stress and brings back joy into the classroom every daymdashwhile increasing time for meaningful instruction and learning Watch the videos at httppaxisorgnewsvideos to learn more about PAX in action and listen to the teachers administrators and students speak up


Explaining the Brain to Children

httpsvimeocom109042767


Video Clip

30

15

442016


Happy Brain vs Worry Brain

31

Color drawings source httppracticalkatiecom20121105the‐worry‐brain


Example of a Second Tier Intervention

32


16

442016

Another Example of Second Tier Intervention

Support for Students Exposed to Trauma (SSET) a series of 10 lessons with a structured approach that aims to reduce distress resulting from exposure to trauma Designed to be implemented by teachers or school counselors in groups of 8 to 10 middle school students the program includes a wide variety of skill‐building techniques geared toward changing maladaptive thoughts and promoting positive behaviors It is also intended to increase levels of peer and parent support for affected students


Example of an Evidence‐Based Treatment in the Third Tier



17

442016


Secondary Trauma

35


001


httpgucchdtacentergeorgetowneduTraumaInformedCareModule3ResourceshtmlSelf‐Care

Self‐Care Resources

18

Slide 35

001 synthesize above and show video00 1062014

NrsquoS MENTAL HEALTH GEORGETOWN UNIVERSITY

442016

Self Care Apps and Websites

bull Flipagram bull Provider Resilience bull Wild Divinecopy bull GPS for the Soul bull Cardio Buddy bull Mediation Oasis Apps bull Stress Check bull Mindfulness Training System bull Streakscom bull IChill App (Peter Levine) bull Mindfulness Bell bull Narrative Therapy Questions bull httpplumvillageorgmindful (Narrative Qrsquos) ness-practicemindfulness-bull Brain Wave software bull Inner Balance bull httpsocialworkbuffaloedur bull Happify esourcesself‐care‐starter‐

kithtml

copy 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDRE 37

To Learn More about Trauma and HealingExcellent Resources by Van der Kolk and Perry


19

442016

Questions and Contact Info

Sherry Peters

slp45georgetownedu

Or

shepeterspagov


20

442016

What is Trauma

How do you define trauma

What may cause trauma


Individual trauma results from

bull an event series of events or set of circumstances that is

bull experienced as physically or emotionally harmful or life threatening and that has

bull lasting adverse effects on the individualrsquos functioning and mental physical social emotional or spiritual well‐being



2

442016












3

442016








ACE Study Continued






4

442016







ndash Emotional

ndash Physical






5

442016



11




12


6

442016


Suicide Attempts

13



Adult Alcoholism

14


7

442016



15





8

442016



__ 0 __ 6

__ 1 __ 7

__ 2 __ 8

__ 3 __ 9

__ 4 __ 10

__ 5




Video Clips


9

442016











Resilience



lives


10

442016

















bull Helping others




11

442016






12

442016





25



8 Modules




13

Youth Mental


442016


5 Issue Briefs







eg CBITS or SSET

egTF‐CBT


PAX


14

442016







Video Clip

30

15

442016



31




32


16

442016







17

442016


Secondary Trauma

35


001




18

Slide 35



442016



kithtml




19

442016


Sherry Peters

slp45georgetownedu

Or

shepeterspagov


20

442016












3

442016








ACE Study Continued






4

442016







ndash Emotional

ndash Physical






5

442016



11




12


6

442016


Suicide Attempts

13



Adult Alcoholism

14


7

442016



15





8

442016



__ 0 __ 6

__ 1 __ 7

__ 2 __ 8

__ 3 __ 9

__ 4 __ 10

__ 5




Video Clips


9

442016











Resilience



lives


10

442016

















bull Helping others




11

442016






12

442016





25



8 Modules




13

Youth Mental


442016


5 Issue Briefs







eg CBITS or SSET

egTF‐CBT


PAX


14

442016







Video Clip

30

15

442016



31




32


16

442016







17

442016


Secondary Trauma

35


001




18

Slide 35



442016



kithtml




19

442016


Sherry Peters

slp45georgetownedu

Or

shepeterspagov


20

442016








ACE Study Continued






4

442016







ndash Emotional

ndash Physical






5

442016



11




12


6

442016


Suicide Attempts

13



Adult Alcoholism

14


7

442016



15





8

442016



__ 0 __ 6

__ 1 __ 7

__ 2 __ 8

__ 3 __ 9

__ 4 __ 10

__ 5




Video Clips


9

442016











Resilience



lives


10

442016

















bull Helping others




11

442016






12

442016





25



8 Modules




13

Youth Mental


442016


5 Issue Briefs







eg CBITS or SSET

egTF‐CBT


PAX


14

442016







Video Clip

30

15

442016



31




32


16

442016







17

442016


Secondary Trauma

35


001




18

Slide 35



442016



kithtml




19

442016


Sherry Peters

slp45georgetownedu

Or

shepeterspagov


20

442016







ndash Emotional

ndash Physical






5

442016



11




12


6

442016


Suicide Attempts

13



Adult Alcoholism

14


7

442016



15





8

442016



__ 0 __ 6

__ 1 __ 7

__ 2 __ 8

__ 3 __ 9

__ 4 __ 10

__ 5




Video Clips


9

442016











Resilience



lives


10

442016

















bull Helping others




11

442016






12

442016





25



8 Modules




13

Youth Mental


442016


5 Issue Briefs







eg CBITS or SSET

egTF‐CBT


PAX


14

442016







Video Clip

30

15

442016



31




32


16

442016







17

442016


Secondary Trauma

35


001




18

Slide 35



442016



kithtml




19

442016


Sherry Peters

slp45georgetownedu

Or

shepeterspagov


20

442016



11




12


6

442016


Suicide Attempts

13



Adult Alcoholism

14


7

442016



15





8

442016



__ 0 __ 6

__ 1 __ 7

__ 2 __ 8

__ 3 __ 9

__ 4 __ 10

__ 5




Video Clips


9

442016











Resilience



lives


10

442016

















bull Helping others




11

442016






12

442016





25



8 Modules




13

Youth Mental


442016


5 Issue Briefs







eg CBITS or SSET

egTF‐CBT


PAX


14

442016







Video Clip

30

15

442016



31




32


16

442016







17

442016


Secondary Trauma

35


001




18

Slide 35



442016



kithtml




19

442016


Sherry Peters

slp45georgetownedu

Or

shepeterspagov


20

442016


Suicide Attempts

13



Adult Alcoholism

14


7

442016



15





8

442016



__ 0 __ 6

__ 1 __ 7

__ 2 __ 8

__ 3 __ 9

__ 4 __ 10

__ 5




Video Clips


9

442016











Resilience



lives


10

442016

















bull Helping others




11

442016






12

442016





25



8 Modules




13

Youth Mental


442016


5 Issue Briefs







eg CBITS or SSET

egTF‐CBT


PAX


14

442016







Video Clip

30

15

442016



31




32


16

442016







17

442016


Secondary Trauma

35


001




18

Slide 35



442016



kithtml




19

442016


Sherry Peters

slp45georgetownedu

Or

shepeterspagov


20

442016



15





8

442016



__ 0 __ 6

__ 1 __ 7

__ 2 __ 8

__ 3 __ 9

__ 4 __ 10

__ 5




Video Clips


9

442016











Resilience



lives


10

442016

















bull Helping others




11

442016






12

442016





25



8 Modules




13

Youth Mental


442016


5 Issue Briefs







eg CBITS or SSET

egTF‐CBT


PAX


14

442016







Video Clip

30

15

442016



31




32


16

442016







17

442016


Secondary Trauma

35


001




18

Slide 35



442016



kithtml




19

442016


Sherry Peters

slp45georgetownedu

Or

shepeterspagov


20

442016



__ 0 __ 6

__ 1 __ 7

__ 2 __ 8

__ 3 __ 9

__ 4 __ 10

__ 5




Video Clips


9

442016











Resilience



lives


10

442016

















bull Helping others




11

442016






12

442016





25



8 Modules




13

Youth Mental


442016


5 Issue Briefs







eg CBITS or SSET

egTF‐CBT


PAX


14

442016







Video Clip

30

15

442016



31




32


16

442016







17

442016


Secondary Trauma

35


001




18

Slide 35



442016



kithtml




19

442016


Sherry Peters

slp45georgetownedu

Or

shepeterspagov


20

442016











Resilience



lives


10

442016

















bull Helping others




11

442016






12

442016





25



8 Modules




13

Youth Mental


442016


5 Issue Briefs







eg CBITS or SSET

egTF‐CBT


PAX


14

442016







Video Clip

30

15

442016



31




32


16

442016







17

442016


Secondary Trauma

35


001




18

Slide 35



442016



kithtml




19

442016


Sherry Peters

slp45georgetownedu

Or

shepeterspagov


20

442016

















bull Helping others




11

442016






12

442016





25



8 Modules




13

Youth Mental


442016


5 Issue Briefs







eg CBITS or SSET

egTF‐CBT


PAX


14

442016







Video Clip

30

15

442016



31




32


16

442016







17

442016


Secondary Trauma

35


001




18

Slide 35



442016



kithtml




19

442016


Sherry Peters

slp45georgetownedu

Or

shepeterspagov


20

442016






12

442016





25



8 Modules




13

Youth Mental


442016


5 Issue Briefs







eg CBITS or SSET

egTF‐CBT


PAX


14

442016







Video Clip

30

15

442016



31




32


16

442016







17

442016


Secondary Trauma

35


001




18

Slide 35



442016



kithtml




19

442016


Sherry Peters

slp45georgetownedu

Or

shepeterspagov


20

442016





25



8 Modules




13

Youth Mental


442016


5 Issue Briefs







eg CBITS or SSET

egTF‐CBT


PAX


14

442016







Video Clip

30

15

442016



31




32


16

442016







17

442016


Secondary Trauma

35


001




18

Slide 35



442016



kithtml




19

442016


Sherry Peters

slp45georgetownedu

Or

shepeterspagov


20

Youth Mental


442016


5 Issue Briefs







eg CBITS or SSET

egTF‐CBT


PAX


14

442016







Video Clip

30

15

442016



31




32


16

442016







17

442016


Secondary Trauma

35


001




18

Slide 35



442016



kithtml




19

442016


Sherry Peters

slp45georgetownedu

Or

shepeterspagov


20

442016







Video Clip

30

15

442016



31




32


16

442016







17

442016


Secondary Trauma

35


001




18

Slide 35



442016



kithtml




19

442016


Sherry Peters

slp45georgetownedu

Or

shepeterspagov


20

442016



31




32


16

442016







17

442016


Secondary Trauma

35


001




18

Slide 35



442016



kithtml




19

442016


Sherry Peters

slp45georgetownedu

Or

shepeterspagov


20

442016







17

442016


Secondary Trauma

35


001




18

Slide 35



442016



kithtml




19

442016


Sherry Peters

slp45georgetownedu

Or

shepeterspagov


20

442016


Secondary Trauma

35


001




18

Slide 35



442016



kithtml




19

442016


Sherry Peters

slp45georgetownedu

Or

shepeterspagov


20



442016



kithtml




19

442016


Sherry Peters

slp45georgetownedu

Or

shepeterspagov


20

442016


Sherry Peters

slp45georgetownedu

Or

shepeterspagov


20

Trauma Informed Care: What Educators Need to Know · 2018. 8. 2. · Registry of Evidence‐based...

Documents

Transcript of Trauma Informed Care: What Educators Need to Know · 2018. 8. 2. · Registry of Evidence‐based...