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Think Trauma 9.26.18

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Carissa Rountree

on 8 November 2018

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Transcript of Think Trauma 9.26.18

Pronoun (Optional)
One thing I admire about my clients or participants...
Training Introduction
Understanding Traumatic Stress
Trauma’s Impact on Development
What Sexual and Reproductive Health Educators and Service Providers Can Do
Stretch Break
Resources and Closing
Jackie Ackeifi and Carissa Rountree

Trauma-Responsive Sex Education

Define trauma and its symptoms, as well as methods people may use to cope with traumatic stress;

Understand how stages of child development can be impacted by trauma; and

Respond to behavior using a trauma-responsive approach.
Adapted from: Think Trauma:
A Training for Staff in
Juvenile Justice and Residential Settings (2012)

Developed by: Dr. Monique Marrow, Dr. Joseph Benamati,
and the NCTSN Juvenile Justice Treatment Subcommittee

Funding for this project was generously provided by
The DeMartini Family Foundation
Self-Care Reminder
Do something regulating
Step out and take a break
Talk to someone you trust
How would you...
Define trauma?
Exposure to actual or threatened death, serious injury or sexual violation
Instrusive Symptoms
Images, sensations, or memories of the traumatic event recur uncontrollably.
Disturbing thoughts;
Physiological reactions;
Intense or prolonged
Kari's Intrusive Thoughts
Kari, a young man who was shot by a robber who stole his gold chain, spoke about his assailant.
Avoidance Symptoms
Alteration in
Arousal + Reactivity

Trauma Can Interfere with Development
Childhood and adolescence are times of rapid and constant change

Trauma at any age can interefere with development

Developmental tasks build on foundations from earlier years
Young Children
Some key developmental tasks:

Develop secure attachment with caregiver
Understand behaviors' impact on the world (empowerment)
Recognize and respond to emotional cues (empathy)
Develop greater independence and capacity to assess danger
Begin self-concept and self esteem
Motor development
Language development
Empowerment, Voice and Choice
Cultural, Historical, Gender Responsivity
Trauma Competence
Trustworthiness and Transparency

Healthy Sexuality Messages
I can't get this dude out my head. I see him every day, every day. Every night I see this dude. And he's locked up.
Avoidance of internal or external reminders.

May include:

Thoughts, feelings, physical sensations
People, places, objects
Activities, situations, conversations

May include:

Irritable or aggressive behavior
Self destructive behavior
Jumpiness or quick to startle
Problems concentrating
Sleep disturbance
Negative Alterations in Cognition or Mood

May include:

Persistent negative emotion
Inability to remember parts of traumatic event
Difficulty experiencing positive emotion
Feeling detached from others
Persistent exaggerated negative expectations
Persistent distorted blame of self or others
Mentally separating self from experience
May experience the self as detached from the body, on the ceiling, somewhere else in the room
May feel as if in a dream or unreal state
Numbing: Ian Loses His Fear
So a lot of things that made me scared or made me nervous, they don't scare me no more. They don't affect me.

Like, if a whole bunch of dudes kept looking at me, I used to feel nervous. And, if someone kept on like giving me mean looks? I used to get nervous.

It don't happen no more. It's like some of the feeling is just gone. If they look at me now, I look at them right back like, "what?"
The Invisible Suitcase
"No one loves me"
"Grown ups lie"
"They're going to hurt you"
"I'm stupid"
"So what?"
"It's your fault"
Anonymous Submission to
Dissociation Art

Trauma Reminders
Things, events, situations, places, sensations, and even people that consciously or unconsciously connect with a trauma event.
School-Age Children (6-12)
Trauma's impact on tasks:

Sustain attention for learning/problem solving
Difficulty sleeping
Increase emotional/behavioral control
Limited coping (dysregulation)
Specific anxieties/fears
Concept of right/wrong less rigid, includes gray
Often confused due to lack of protection
Increase self-concept & self-esteem
Regression to younger behaviors or trauma itself causing self-concept
Develop stronger peer relationships
Isolation/withdrawal due to poor emotional and behavioral regulation
Impact on Adolescent Development


Behaviorally & Emotionally


Identity Development & Future Orientation
Youth may have...
difficulty with regulating attention and executive functioning
memory impairments
difficulty with test taking and ability to call up learned information
IQs 8 or more points lower than non-traumatized youth
70% of justice-involved youth have a diagnosable learning disability
During this time adolescents...
establish adult vocational goals
develop independent identities
begin to plan for and imagine their futures
forge new relationships with mentors and role models
Youth may...
have a sense of foreshortened future or cannot see any kind of future for themselves
feel ill-equipped to handle the future because of the life skillls they've missed along the way
Trauma's Impact
Youth may have...
body development that may feel more distressing
trauma reminder because of body
physical coping mechanisms such as cutting, piercing, tattooing, and maladaptive eating
increased use of alcohol and substances to try controlling or changing emotions and physical sensations
alterations in the immune system
During this time adolescents...
Adjust to outward changes in the body
Adjust to increased hormone levels
Key Tasks
Youth may have...
experiences of isolation and withdrawal
experiences of persistent distrust and suspiciousness of others
continued expecation of maltreatment
difficulty in perspective-taking and enlisting others as allies
difficulty with establishing appropriate social boundaries
During this time, adolescents...
develop stable and constructive peer relationships, sometimes including romantic relationships.
Trauma's Impact
Key Tasks
Trauma's Impact
Carmen's Story
Trauma's Impact
Key Tasks
Physical Development
Social Development
Behavioral &
Emotional Development
Cognitive Development
Identity Development & Future Orientation
Key Tasks
Behavioral Impact
Youth may have difficulty...
making realistic appraisals of danger/safety
governing behavior to meet longer-term goals
As a result, youth may...
engage in risk-taking
avoid any risk
During this time, adolescents...
develop increased impulse control, ability to defer gratification, and ability to think through consequences
Emotional Impact
Young people who have experienced trauma may have difficulty...
with self-regulation
describing feelings/internal states
communicating wishes and desires
Understanding Traumatic Stress
Trauma's Impact on Development
Film Excerpt
What similarities do you see in your work or with your clients?

What beliefs do you think the classroom teacher and police officers may hold?

What do you think contributes to Chiron's thoughts, feelings, and actions?
Part 1:
What is a potentially traumatic event?

We Learn by Experience
Fight | Flight | Freeze
Breathing Rate Rises
Heart Rate + Blood Pressure Rise
Release of Adrenaline + Cortisol
How Individuals
Respond to
Traumatic Stress

What Providers Can Do
Coping Stategies
individuals use consciously or unconsciously to tolerate adversity, disadvantage, or disability, without correcting or eliminating the underlying condition.
Anger or aggression
Hostility and coldness
Poor concentration
Difficulty calming down after anger outburst
Problems with change and transition
Guarded and anxious behavior
Checking out (laying head on desk)
Rejecting support from peers and adults
Coming in and out of group
Picking fights
Antagonizing facilitator (distrust)
Challenging Coping Strategies in Groups
What Providers Can Do
What Providers Can Do
"Tuning In" to Behavior
What Providers Can Do
Head on desk
No one can help
This is dumb
What Providers Can Do
Focus on feelings and thoughts

find words
to express feelings

expressions of emotions,
, &
Resources and Closing
Secondary Traumatic Stress
The emotional residue or strain of exposure to working with those suffering from the impact of traumatic events. It differs from burn-out, but
can coexist. STS can occur due to exposure on one case or due to a "cumulative" level of trauma.
Possible Effects of Secondary Traumatic Stress
Dreaming or continually thinking about those traumatic events
Trouble sleeping
Frequent reminders of the trauma or trying to solve the problem
Purposely avoiding areas of work environment, not coming to work
Feeling anxious or fearful
Feeling depressed, overwhelmed, or hopeless
Self Care Inventory
Self Care
What events did you see that you consider traumatic?

What do you notice about Chiron's reaction in the Principal’s office?

How does this shape our understanding compared to our initial reactions?

What are your thoughts on the staff and school's response?
Part 2:
What's the connection to sexuality and sexual health?

Compare: What makes something traumatic as opposed to just stressful?
• Physical Self-care
• Psychological Self-Care
• Emotional Self-Care
• Spiritual Self-Care and
• Workplace Self-Care

Definition from https://www.nctsn.org/what-is-child-trauma/about-child-trauma
Physical, emotional, or sexual abuse
Foster care (dis)placement
Caregiver incarceration
Abandonment and neglect
Community violence and victimization
Medical trauma, injury, illness
Death including suicide and murder
Witnessing drug use
House fires
Domestic or intimate partner violence
Serious accidents
Natural disasters
1 in 4
students have experienced a traumatic event.
1 in 10
has been sexually assaulted (NCTSN, 2008).

Creating a Safer Group Environment
Provide Content Warnings
Consider Signs of Symptoms
Offering Regulating Strategies
Resilience is the ability to recover and show early and effective adaptation following a potentially traumatic event.
A person with a full belly has many problems.
A person with an empty belly has one problem.
Development's Missing Stairs
When children endure multiple traumatic events over long periods of time, they are especially likely to have multiple gaps in their development.
What are possible traumatic experiences your participants may have gone through?
Potentially Traumatic Events
What are symptoms (feelings or reactions a person might have) to a traumatic experience?
What are behaviors your participants might use to deal with symptoms of trauma?
Trauma Symptoms
Coping Strategies
What are events, situations, or sensations that may remind our participants of a traumatic
Trauma Reminders
Group Agreements
Trauma Principles
Sexuality Policies
What Providers Can Do
Full transcript