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  • I imagine this is something that you all do on a regular basis interacting with courts, dcfs, pediatricians, and schools
  • Bearing witness

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  • 1. Supporting Children and Families UnderStress: Resilient and Trauma-Informed Schools Audra Langley, Ph.D.UCLA Semel Institute for Neuroscience & Human Behavior NCTSN Trauma Services Adaptation Center for Resiliency, Hope, and Wellness in Schools ALangley@mednet.ucla.edu
  • 2. Prevalence of Exposure toTraumatic Events amongYouth More and more youth are experiencing traumatic events – Family and interpersonal violence – Community violence – Accidents – Natural and technological disasters – Terrorism – Medical Trauma
  • 3. A Startling Number of Students Are Exposed to Violence 2% Direct assault 6% No violence • The No violence 27% Violence not involving Gun or knife Witness violence a weapon 48% 40% Direct assault 54% & witness 23%National Survey of Adolescents LA Unified School District 1995 6th-Grade Students, 2004
  • 4. Distress from Trauma Has Negative Effects on Students in the Classroom• Classroom performance declines due to… – Inability to concentrate – Flashbacks and preoccupation with the trauma – Avoidance of school and other places• Other behavioral and emotional problems develop that can impede learning and interpersonal relations – Substance abuse – Aggression – Depression
  • 5. Why Schools: Access andDecreasing Disparities in Care Most youth with mental health needs do not seek treatment Many internalizing disorders in children go undetected Of youth who do receive intervention, 75% access through schools Schools are ideal settings for detection and intervention with traumatized children – Trauma affects school performance – Barriers to access are partially removed Disparities: Low SES and ethnic minority children
  • 6. Partnering with Schools and Communities is critical– Establishing and maintaining stakeholder relationships  Why child mental health is important to them  Education: Training, Products, and access to community-informed Interventions/Services  Learn their language and speak it– Partnering is an iterative process:  Needs assessment  Listening and incorporating input
  • 7. Gaining support from school community Liaison with teachers and administration – Find ideal time for education and intervention – Present education about trauma  Students and Trauma DVD  Trauma Awareness Powerpoint Slides  Child Trauma Toolkit for Educators Outreach to parents – Depending on community and school issues, consider working with parent leaders to engage parents in process – Develop parent component depending on needs of parents
  • 8. Trauma impacts learning andacademic outcomes  Decreased IQ and reading ability (Delaney-Black et al., 2003)  Lower grade-point average (Hurt et al., 2001)  More days of school absence (Hurt et al., 2001)  Decreased rates of high school graduation (Grogger, 1997)  Increased expulsions and suspensions (LAUSD Survey)  DVD
  • 9. Use a “Trauma Lens” to better understand a child’s behavior.A shift in perspective from: “What is wrong with this child?” to“What has this child been through?” 9
  • 10. Trauma narrative picture
  • 11. We have to ask “what they havebeen through” Children may have never been given the opportunity to tell their story Identify those in need—not only the ones who are already on educator radars – High Risk Students/Schools – Grade Level or Universal Screening
  • 12. We Must Equip Schools and Familiesto Support Children’s Recovery Efforts Provide concrete information to parents and educators on what they can do to support youth under stress or recovering from traumatic events
  • 13. How does distress from trauma affect students inthe classroom? Academic, social and behavioral problems:  Failing to understand directions  Overreacting: comments from teachers & peers, bells, physical contact, doors slamming, lighting, sudden movement  Difficulty with authority, redirection, or criticism  Misreading context  Failing to connect cause and effect  Clinginess and worry about safety  Somatic Complaints  Incomplete school work or decreased school performance  Absenteeism 18
  • 14. What can I do to support my students? Maximize the child’s sense of safety. Accept no bullying or teasing. Give youth consistency and choices Predictable routines, clear expectations, consistent rules, and immediate feedback. Understand that youth process their experiences through their interactions with others (Know this is a way to cope with trauma). Express positive thoughts for the future. Help youth to cope with day to day problems. 19
  • 15. As a parent, you are in the best position to help your childafter a stressful eventComo padres, ustedes están en la mejor posición paraayudar a su hijo/a después de un evento estresante Listen Protect Connect Escuchar Proteger Conectarhttp://www.ready.gov/sites/default/files/documents/files/PFA_SchoolCrisis.pdfhttp://www.cphd.ucla.edu/pdfs/PFA_Ready%20Parent_Final_8.5x11.pdf
  • 16. AND We Must Increase School-Based Mental Health Services•Access to state of the artinterventions to addressstudents’ mental health needs. •School employed clinicians •Agencies collocating in schools
  • 17. What interventions exist?Thorough review of the literature reveals at least 30programs designed for schools “How Schools Can Help Students Recover from Traumatic Experiences” http://www.rand.org/pubs/technical_reports/TR413.htmlOnly 7 have been evaluated in any kind of controlledtrial – All use cognitive-behavioral skills  Psycho-education; Relaxation; Affect regulation; Cognitive coping; Trauma narrative; In vivo mastery of trauma reminders; Enhancing safety – Some also use experiential activities
  • 18. Cognitive Behavioral Intervention for Trauma in Schools (CBITS) For Children • 10 group-therapy sessions for trauma symptoms • 1-3 individual sessions for exposure to trauma memory and treatment planning For Parents For Teachers • 2-4 group sessions to…• In-service to educate about… − Educate about trauma – How trauma can affect students − Provide parenting support – How to detect signs of trauma • Family outreach and liaison – How to support traumatized for other social services students in the classroom
  • 19. CBITS• Based on current evidence and practice guidelines• Easy-to-follow treatment manual with handouts for students• Short training (two days maximum)• Developed in schools with multicultural youth to be feasible in the school setting• CBITS has the flexibility to meet the needs of students and families from diverse backgrounds – Urban, suburban, rural, Native American – Recent immigrants and refugees – in multiple languages
  • 20. Other Group Interventions used inschools• TARGET-Trauma Affect Regulation: Guide for Education and Therapy • Uses “FREEDOM” steps: Focus, recognize triggers, emotion self- check, evaluate thoughts, define goals, options, make a contribution • Some evidence• SPARCS-Structured Psychotherapy for Adolescents Responding to Chronic Stress •Uses mindfulness, problem-solving, meaning-making, relationships and communication, distress tolerance, psycho-education • Not yet well tested
  • 21. Summary Trauma lens, Identification, Educator and Parent Support for Recovery, MH interventions= Trauma Informed School Trauma Informed Schools lay the foundation for resiliency, hope, and wellness among students Resilient, hopeful, well students are better able to learn
  • 22. Thank you for your time, attention, …and what you do each and every day.27