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Resilience Project

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Keith Harris

on 14 September 2016

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Transcript of Resilience Project

This term describes both children’s exposure to multiple chronic, stressful events, often of an invasive, interpersonal nature, and the wide-ranging, long-term impact of this exposure (ex. abuse, poverty, neglect).

Source: NCTSN


WHAT IS TRAUMA?
ACEs Study Outcomes

ACEs are common

ACEs occur together

ACEs are powerful predictors of adult outcomes

The effects of ACEs are strong across groups of people from all different races & socio-economic factors
ASN's Resilience Project:
Trauma Informed Schools

Complex Trauma
Abuse - physical, emotional, sexual
Neglect/abandonment
Bullying
Life-threatening health conditions
Victimization
Domestic/Community Violence
Illness or death of loved one, caregiver
Removal from home
Auto or other serious accident
Natural Disaster
Acts or threats of terrorism
Human Trafficking
Examples of Traumatic Events
Trauma's Impact on Student Learning

Trauma can impair learning

Traumatized students may experience physical & emotional distress

Trauma can impact school performance
Source: NCTSN & SAMHSA
FACT: Trauma can impact school
performance

Lower GPA
Higher rate of absences
Increased drop-out rate
More suspensions & expulsions
Decreased reading ability
Source: NCTSN & SAMHSA
Trauma Informed Schools:
Key Components
Shared definition of trauma
Enhancing trauma awareness throughout the school community
Engaging in an on-going process of assessment/re-assessment of school climate
Developing trauma informed discipline policies
Understanding of the impact of secondary stress & vicarious trauma on staff
On-going staff trainings & professional development
Source: USC, Treatment & Services Adaptation Center
Trauma Informed Schools: Best Practices
Maintain structure & routines in and out of the classroom
Give students choice & sense of control when appropriate
Provide safe spaces where youth can process situations (ex: Peace Rooms)
Avoid power struggles
Provide unconditional positive regard
Maintain high expectations
Check your assumptions about youth: observe & ask questions rather than jumping to conclusions ('what happened to you?' vs. 'what's wrong with you?')
Restorative Justice Practices
Provide opportunities to belong & give back (peer mentoring, peer tutoring, support groups)
Offer creative/visual/performing arts, yoga, mindfulness, meditation, sports
SELF CARE
Positive Outcomes of Becoming
a Trauma Informed School
Reduction in drop-outs, suspensions, expulsions
Increase in attendance
Some schools have had up to 90% reduction in suspensions
Improved teacher satisfaction, and staff retention
Improved academic achievement and test scores
Important Things to Keep in Mind
Becoming trauma-informed is a long-term process, not just a 1-2 day training

We should ask the question, "What happened to you?" rather than "What's wrong with you?"

You do not have to be a therapist to be therapeutic.

Invest your time on the front end -
being proactive rather than reactive

What we may see...
The Impact
Presented by
the ASN Clinical Team
Sarah Bowie, LCSW
Keith Harris, LCSW
Sabrina Hughey, LSW, M. Div.
Kate Sandy, LCSW

Source: NCTSN & SAMHSA
Physical symptoms like headache & stomachaches
Unpredictable and/or impulsive behavior
Over or under-reacting to loud noises, physical contact, sirens, sudden movements, etc.
Intense reactions to reminders of their traumatic event
Hypervigilance, thinking others are violating their personal space
Blowing up when being told what to do by an authority figure
Resisting transition or change
Lower GPA
Higher rates of absences
Increased drop-out rates
More suspensions & expulsions
Decreased reading ability
Brain Structure
The Stress Response
Typical Brain Development Responses vs. Developmental Trauma Response
Typical Brain Development
Response
Developmental Trauma Response
e
The brain does not stop developing until mid-late 20s (pre-frontal cortex).

Not everyone responds to trauma in the same way (protective factors).

New pathways can be made, brain can be healed, our students can succeed.

Resilience (positive capacity of people to cope with stress and life problems) is something we can help students increase.

Emotional regulation is like a muscle that we can help students to build.
The Impact: Physical
Headache
Stomachache
Hyper vigilance
Sleep disturbance
Enuresis
Flashbacks
Dissociation
The Impact: Emotional
Unpredictable or impulsive behavior
Inability to regulate emotions
Risk-taking behaviors
Anxiety
Self-harming
Difficulty trusting people
Isolation/withdrawal from peers


The Impact: Spiritual
- Belief that the world is an unsafe
- I'm a bad person
-Hopelessness
-Lack of Control
- Fear & pessimism about the future

Physical Development
Characteristics
Cognitive
Characteristics
Psychosocial
Characteristics
Identity Development
Characteristics
Key Points
Part of brain responsible for executive function which supports long term thinking, problem solving, goal setting, long term consequence thinking takes the entire period to fully develop

Brain is wiring itself through repetitive experiences, More something happens, the stronger pathway

Brain uses experiences to build template to for a young person to understand the world, make sense of it, and respond to their environment
Typical
Adolescent Development
What does it look like?

Physical Development

Social-emotional Development

Cognitive Development

Identity Development
Rapid gains in height, secondary sex characteristics emerge, continued brain development, hormonal changes
What we see
More sleep, especially sensitive, uncomfortable with affection, erratic mood changes, uncomfortable with sex characteristics, clumsy and awkward
Developing advance reasoning and problem solving, abstract thinking, can take in larger amounts of information, retain it, and apply it in academics, ability to think about thinking
What we see
Heightened self conscious, feeling their emotions are unique, cause and justice orientated, belief system to guide decisions, uneven application of these new skills
Trying to establish identity, establish autonomy, intimate relationships, aware of sexuality, seek achievement, build and sustain healthy relationships with adults
What we see
More time with friends, sexuality questions, more private time, argumentative, changing relaationships with parents, take on roles that will take them to adulthood, better understanding of their emotions and emotions of others, new sks to resolve conflict
Developing independent identity regarding sexuality, ethnicity, family, begin to plan future, new relationships with adults
What we see
Trying new roles on to see what "fits", vacillation between wanting to be in charge and wanting to be ld what to do
Identity Development
More energy spent on moment, difficulty seeing the future

Being part of the system can make idifficult to renegotiate relationships with adults

Disconnection from families and other closer ties
Socio-emotional
Isolates and withdraws

Distrust of others

Expects to be treated poorly

Perspective taking difficulties

Difficulty with healthy boundaries, asking for help

Violence may be seen as normal to relationships

Unhealthy relationships
Cognitive
Difficulty with attention

Memory problems

Hyper arousal- makes taking attention in difficult

High stress, interference recalling information

Uneven application skills

Physical
Body changes can serve as trauma reminders

Somatic complaints

Feeling otu of control can lead to cutting, eating problems, substance abuse, tattoos

Negative body image
Brain is rapidly developing throughout, cortisol levels go up and significantly changes how the brain develops and wires itself
Impact of Trauma on Development
Silver Lining
- fight
- flight
- freeze
We have students who go from 60-100, rather than 0-60.

They struggle to trust the adult figures in their lives, are academically challenged, may have substance use issues, low self- esteem, difficulties with relationships, exhibit disruptive behaviors... and the list goes on.

We have our hands full.









ACE'S
Adverse Childhood Experiences (ACEs) Study
1998 - US CDC's landmark study

18,000 adults with private health insurance were surveyed

Provided detailed information on their childhood experiences as they related to abuse, maltreatment, and family dysfunction

ACE Indicators Include...

Emotional Abuse
Physical Abuse
Sexual Abuse
Physical Neglect
Emotional Neglect
Sustance using household member
Mental ill household member
Witnessed domestic violence
Incarcerated family member
Learning Objectives
Participants will understand:

- Definitions of and types of trauma

- Prevalence of childhood trauma through the Adverse Childhood Experiences Study

- Impact of trauma on brain development

- Impact of trauma on learning and behavior

- The Silver Lining: Resiliency factors & how we can help & how we can help ourselves (self care)
The Resilience Project Overview
The PROBLEM:

Trauma

The IMPACT:

How does trauma impact students?
How does trauma impact YOU?
How does it impact our schools?

Part of the SOLUTION:

Becoming a Trauma Informed School with the support of ASN Clinical Team.
It starts with you.
4 Rs of Trauma-Informed Care
Definition of Childhood Trauma
Three 3 Es -

- An emotionally painful or distressful event

- The experience of the event indices an abnormally intense and prolonged stress response

-The event and experience of the event result in lasting physical and mental effects

-
Realizes
the widespread impact of trauma
and understands potential paths for recovery.
-
Recognizes
the signs and symptoms of trauma in clients, families, staff, and others involved with the system.
-
Responds
by fully integrating knowledge about
trauma into policies, procedures, and practices
-
Resists
re-traumatization.
6 Key Principles of Trauma Informed Practice
1. Safety
2. Trustworthiness and Transparency
3. Peer Support
4. Collaboration and Mutuality
5. Empowerment, Voice and Choice
6. Culturally Responsive
Physical
Intense reactions of the traumatic event

Somatic complaints (headaches, stomachaches)

Feeling out of control can lead to cutting, eating problems, substance use/abuse

Negative body image

Over or under-reacting to loud noises, physical contact, sirens, sudden movement, etc.
Difficulty with attention

Memory problems

Hyper arousal- makes paying attention difficult

High stress, interference recalling information

Uneven application skills

Lower GPA

Higher rates of referrals to Special Education (Diverse Learners)

Increased drop out rates

Decreased reading ability


Cognitive
Socio-emotional/Behavioral
Isolates and withdraws

Distrust of others, and authority figures

Expects to be treated poorly

Perspective taking difficulties

Difficulty with healthy boundaries, asking for help

Violence may be seen as normal to relationships

Unhealthy relationships
Unpredictable and/or implusive behavior

Hypevigiliance, thinking others are threatening/invading space

Resisting transitions or change

Higher rates of suspensions

Lower attendance rates
More energy spent on moment, difficulty seeing the future

Being part of the system can make it difficult to renegotiate relationships with adults

Disconnection from family and other closer ties
Identity Development
Impact of Trauma on Adolescent Development
Deshon's Story
source: Project Thrive
Compassion

Empathy

Vicarious/Secondary Trauma

Compassion Fatigue

Burnout/ Rust-out

Progression of Burnout / Rust-out
Cycle of Compassion &
The Importance of Self Care
Trauma changes perception & worldview
Guiding Principles of Trauma Informed Practice
Safety
Trust
Collaboration
Empowerment/Choice/Voice
Peer Support
Cultural Competency/Humility
Traumatic Stress & Brain Development
Young people who have experienced/witnessed trauma may have challenges:

managing fears, anxieties & agression
sustaining attention for learning & problem-solving
controlling impulses, manage physical responses to danger, and take protective actions
Source: Bruce D. Perry 2004-2015
GROUP ACTIVITY

1) What characteristics/behavior do we see in a young person who has experienced/witnessed trauma?

2) What do we do in our school/classroom when we have a student with trauma symptoms?

3) What do we need to do better to support students who have experienced/witnessed trauma?



GET IN CHICAGO YOUTH - Trauma Exposure

Traumatic Incident

Total Youth Exposed

Experienced Emotional Abuse 79.50%
Experienced Physical Abuse 73.30%
Experienced Violent Act(s) 68.90%
Experienced Sexual Abuse 34.10%
Witnessed Violent Act(s) 73.30%
Witnessed Violent Death 64.40%

How often do you think about these things?

All of the Time 40.90%
Most of the Time 18.20%
Total 59.10%


cw
Common Reactions to Traumatic Exposure
Violence is a Public Health Crisis

Violence affects:
• Youth who were injured
• Youth who witnessed injury or death
• Youth who witnessed any part of the violence
• Youth whose friends were injured or killed
• Youth whose friends perpetrated the violent acts
• Youth at the same school
• Staff working with youth
• Parents and community members
Media creates greater sense of danger and
vulnerability
Source: Ann & Robert Lurie Children's Hospital of Chicago

Re-Experiencing
• Flashbacks
• Intrusive thoughts
• Nightmares



Avoidance
• Emotional numbing
• Behavioral inhibition
• Dissociation
Hyper-arousal
• Hyper-vigilance
• Irritable Outbursts
Negative Alterations in
Cognition
• Anger
• Depression or sadness
• Withdrawal
Source: American Psychiatric Association, 2013
Role of the Caring Adult
Be Aware:
Look for changes in behavior and be
informed about signs and symptoms of trauma exposure
Be Available:
Listen to youth and help them to
problem-solve

Be Resourceful:
Connect students to mental health
professionals in your community; Know your limits (your own risk/resilience, trauma history) and
your resources.

REGULATE, RELATE, then REASON
Source: Ann & Robert Lurie Children's Hospital of Chicago
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