2. Trauma is…Trauma is…
An experience that is emotionally
painful, distressing or shocking
which can result in lasting
emotional and physical effects.
3. Types of TraumaTypes of Trauma
• Acute Trauma
• Complex Trauma
• Developmental
Trauma
• Post-traumatic Stress
Disorder
“When complex trauma takes
place in the context of a
child’s physical, social and
emotional development, it
negatively impacts the child’s
ability to negotiate
developmental milestones
successfully.”
From Creating Trauma-Sensitive Schools by
Tony Evers
4. Trauma MemoriesTrauma Memories
Differ from typical memories:
• Stored in the emotional brain
• No control over their retrieval
• Triggered by sensory stimuli or emotions
• Event is re-experienced, as opposed to re-called
• Memory may be disassociated, partial or
disconnected
• No language is associated with the memory
5. PrevalencePrevalence
According to the Adverse Childhood Experiences Study by the Centers for Disease Control & PreventionAccording to the Adverse Childhood Experiences Study by the Centers for Disease Control & Prevention
Issues within the Family SystemIssues within the Family System
• Substance abuseSubstance abuse 27%27%
• Parental separation/divorceParental separation/divorce 23%23%
• Mental illnessMental illness 19%19%
• Domestic ViolenceDomestic Violence 13%13%
• Incarcerated household memberIncarcerated household member 5%5%
AbuseAbuse
• PsychologicalPsychological 11%11%
• PhysicalPhysical 28%28%
• SexualSexual 21%21%
NeglectNeglect
• EmotionalEmotional 15%15%
• PhysicalPhysical 10%10%
7. Impact on Children & YouthImpact on Children & Youth
• Cognitive & Academic
• Physical
• Emotional
• Spiritual
• Relational
8. Impact on Child’s WorldviewImpact on Child’s Worldview
Typical Development
• Nurturing & stable attachments
with adults
• Belief in a predictable &
benevolent world/ generally
good things will happen to me
• Feeling of positive self-
worth/others will see my
strengths
• Optimism about the future
• Feeling that I can have a
positive impact on the world
Developmental Trauma
• Basic mistrust of
adults/inability to depend on
others
• Belief that the world is an
unsafe place/bad things will
happen & they are usually my
fault
• Assumption that others will not
like me
• Fear & pessimism about future
• Feelings of hopelessness & lack
of control
9. Trauma from an uninformed eyeTrauma from an uninformed eye
• Reactivity & Impulsivity
• Aggression
• Defiance
• Withdrawal
• Perfectionism
10. Trauma-informed PracticeTrauma-informed Practice
Trauma Therapy
• Licensed, clinical mental
health professional
• 1:1 or small group
sessions within a
therapeutic office
• Focus on addressing
trauma reactions &
reducing symptoms
Trauma-informed Practice
• Educators, student support
staff, yd professionals
• Sensitivity &
accommodations occur
throughout the
environment
• Focus on emotional &
physical safety,
empowerment, trust,
choice & collaboration
11. Trauma-informed PracticeTrauma-informed Practice
• Build trusting relationships
• Foster community
• Create predictability
• Build on strengths
• Embed coping strategies into curriculum
• Maintain high expectations
• Collaborate with others
12. Trauma-informed PracticeTrauma-informed Practice
Create Comfort Zones
Sheltered or partially sheltered (barriers)
Comfortable seating
Distractive and regulating activities
Use Student-centered Safety Plans
Identify triggers
Eliminate triggers when possible
Help youth develop coping skills
14. Teach Coping SkillsTeach Coping Skills
• Self-regulation
• Recognizing & naming emotions
• Identifying others’ emotional cues
• Linking feelings to internal & external
experiences
• Identifying and using Comfort Zones
• Assertiveness skills
15. Collaborative Problem SolvingCollaborative Problem Solving
1. Present your observation to the youth
2. Invite student to tell you about it from
their perspective
3. Listen & empathize
4. Summarize problem
5. Invite youth to think of some solutions
6. Summarize idea & try it out
7. Repeat as needed
16. ResourcesResources
• Helping Traumatized Children LearnHelping Traumatized Children Learn
Massachusetts Advocates for Children 2005Massachusetts Advocates for Children 2005
http://www.massadvocates.org/order-book.php
• The Heart of Learning & Teaching Compassion, Resiliency & Academic SuccessThe Heart of Learning & Teaching Compassion, Resiliency & Academic Success
Wolpow, Ray; Johnson, Mona M.; Hertel, Ron; Kincaid, Susan O. 2009
http://www.k12.wa.us/CompassionateSchools/HeartofLearning.aspx
• Creating Sanctuary in Schools 1995Creating Sanctuary in Schools 1995
Bloom, SandraBloom, Sandra
http://www.sanctuaryweb.com/PDFs_new/Bloom%20Sanctuary%20in%20the
%20Classroom.pdf
• Child Trauma Toolkit for EducatorsChild Trauma Toolkit for Educators
National Child Traumatic Stress NetworkNational Child Traumatic Stress Network
http://rems.ed.gov/docs/NCTSN_ChildTraumaToolkitForEducators.pdf
Editor's Notes
Introduce self- faculty in the COE at UIC where I teach course in youth development theory and practice; background in social worker, working primarily in community-based youth development programs serving youth who’ve experienced violence.
Years ago, before I became an educator, I worked at a non-profit that was contracted to provide support services at a DHS program in Chicago serving low-income teens who were pregnant or parenting. The teens were required to attend school from 8:30-4:30 b/c they were receiving financial support from the government through TANF. If they missed more than a day a month their welfare check was cut or outright stopped until they began attending school again. My role as an outside contractor was to work with young people around interpersonal violence- dating violence, sexual assault, family abuse, etc. One day a young woman was referred to me by the TANF case workers bc she had missed school for several weeks and was at risk of losing her welfare benefits. Up until this point, this young woman, we’ll call her crystal, had attended school regularly and actively engaged in classes. She was doing well academically and had a strong peer group. Her sudden withdrawal from school was uncharacteristic and indicated a more serious issue; regardless the government was prepared to cut her off bc that was the policy at the time. When I was finally able to get in touch with her and convince her to come into my office, I learned of the root cause of the change in her behavior and academic engagement. As she told it, at a party one weekend, she had been drugged and raped. She didn’t know who her assailant was and bc of the drugs she couldn’t really recall the details of the assault. When she went to school the following Monday, tons of students knew what had happened to her- apparently the young man had been bragging about it- but no one would step up and tell her who it was. She was devastated, humiliated. She felt like she couldn’t trust anyone at school and that something bad could happen to her at any time. She stopped going to school. She stopped leaving her house all together. She was anxious all the time and experiencing flashbacks. She had no one to talk to about the assault or the betrayal of her former friends. To make matters even more stressful for her, she became pregnant as a result of the rape. This young woman was experiencing acute and developmental trauma. Her behavior was presenting to outsiders as defiance and withdrawal, but in reality, represented a very typical reaction to a traumatic experience. And that’s what we’re here to learn about today. We’ll begin by…
Defining trauma and discussing how it impacts young people’s lives
We will discuss the concept of trauma-informed care and how to create trauma sensitive services and environments
However, this introduction to trauma informed practice will help you begin to think through what trauma-sensitive environments and interventions look like with the youth you work with at TEAM Englewood
Trauma exposure vs. trauma reaction: not all traumatic events have the same impact on children
A traumatic reaction occurs when we are exposed to traumatic events or situations that overwhelm our ability to cope.
ACUTE TRAUMA
Usually a one-time event
Brain responds with Fight, Flight or Freeze
Examples include serious accidents, loss, natural disasters, sexual assault, school shootings and terrorist attacks
COMPLEX TRAUMA
Persists over time
Is a violation of safety within an intimate relationship
Is persistent but unpredictably and episodic
Often progresses over time
Tony Evers, author of “Creating Trauma-sensitive Schools,” says “When complex trauma takes place in the context of a child’s physical, social and emotional development, it negatively impacts the child’s ability to negotiate developmental milestones successfully.” This is what we call developmental trauma. It is the delayed cognitive/academic, physical, emotional, spiritual and social development that results from adverse experiences in childhood or adolescence
Finally, POST-TRAUMATIC STRESS DISORDER is a mental health diagnosis characterized by:
Re-experience the traumatic event
Hyperarousal
Avoiding reminders of the event, constricted behavior and numbing
Dissociation
Intrusive thoughts
When someone experienes trauma, they develop what we call Trauma Memories. These memories differ from typical memories in several ways. For example,…(see above)
ASK: What do I mean by Sensory stimuli-? (voice, touch, smell, sound)
What are some examples? (smell of alcohol, unexpected touch, loud noise, crowded spaces, tone of voice, someone towering above you, darkness); many of these are things that might occur within a classroom or school setting just because of the nature of our schools (for example hallways might be loud and crowded, we may darken classrooms when using multi-media or touch a student on the shoulder to be supportive) When these things happen, even as part of the natural process of schooling, they can provoke a trauma memory in which the student re-experiences the fear, pain, shock and distress of the traumatic event
One of the largest studies ever conducted connecting adverse childhood experiences to later difficulty in health and well being. CDC sampled 17, 421 members of the Kaiser Health Plan in San Diego, CA. Found that almost 2/3 of study participants reported as least one ACE and more than one in five reported 3 or more ACEs. ASK: What is your perception of the rate of these experiences among youth in Chicago?
We know that adverse experiences in childhood and youth have a lasting impact on health and wellness over the course of an individual’s life. I imagine you have seen some of the impact of trauma in your own classrooms. What are some examples of behaviors and outcomes you see among students at TEAM Englewood?
Behaviors:
School Absenteeism —tardies & truancy
Dysregulated eating (under & overeating)
Smoking
Suicide attempts
Illicit drug use & substance abuse
Multiple sexual partners
Self-injurious behaviors (e.g., cutting)
Outcomes:
Autoimmune disorders
Obesity & eating disorders
Substance use disorders
Chronic obstructive pulmonary disease
Depression
Fetal death
Health-related quality of life
Ischemic heart disease
Liver disease
Risk for intimate partner violence
Sexually transmitted infections
Unintended pregnancies
As the number of ACEs increase, the risk of health and behavior problems likewise increases.
Show clips from Dropout Nation (12;20-14:20; 33:40-35:40)- Sparkle on “school is not life” (Cognitive; engaging curriculum)
http://www.pbs.org/wgbh/pages/frontline/dropout-nation/
In this clip, we begin to see the impact of experiencing a trauma- such as surviving a natural disaster and losing a parent- on a young person’s life. In Sparkle we see
Cognitive and academic: negative impact on cognitive functions and academic capabilities, such that children experiencing trauma are
2.5x more likely to fail a grade in school
score lower on standardized achievement tests
more likely to have struggles in receptive & expressive language
suspended & expelled more often
more frequently placed in special education
Cognitive
difficulty with organization, rules and routines;
difficulty understanding cause and effect;
inhibited sense of self and ability to set boundaries or make independent choices; cannot establish own viewpoint and therefore find it hard to understand others’ perspectives (limited empathy);
Often distracted and unfocused; either hypervigilant (taking in everything) or dissociated (taking in nothing); mis-characterized as “inattentive”
Impaired ability to regulate emotions and control impulses; may result in aggressiveness; prone to misinterpreting emotions of others and over-/under-reacting; overwhelmed by feelings of anger, sadness, guilt or shame
Executive functions- goal setting, anticipating consequences, initiating and carrying out plans and evaluating outcomes; trauma can lead to a bleak perspective, expectations of failure, low sense of self-worth, lack of future-orientation; in other words, youth who are unable to plan, anticipate and hope
Engaging in the Curriculum- traumatic experiences can deplete motivation and internal resources for academics
Physical- broken bones; bruises
Emotional- persistent fear, inability to trust, inability to regulate emotions
Spiritual- loss of faith in humankind or concept of benevolent God
Relational- in the case of complex trauma, the child’s template for relationships becomes eroded
Caregiver may be unpredictable and unreliable
Child may not learn to regulate emotions or calm herself down when experiencing intense emotions
Ability to learn by exploring may take a back seat to need for protection and safety
Child begins to perceive world as dangerous; feels vulnerable and distrustful of others
Child has difficulty sensing how he impacts others
Child’s lack of control over her life leads to hopelessness and helplessness
Overall, trauma can arrest or impair movement through the developmental stages; our challenge is to look at the developmental stage of the young person and meet the needs at that level so that the person can grow and learn the skills to move to the next stage of development
Worldview is the lens through which a person sees every experience. How would a child who’s experienced developmental trauma view the everyday challenges of their environment? For example, how might this child view school? Peers? Neighborhood? (think about Sparkle saying “I can’t let you in.”)
Remember early trauma is more resistant to treatment and healing; for these children, their stress system is on constant alert; a door slamming may cause increased heart rate, difficulty breathing, withdrawal, for example.
These characteristics often lead to harmful labeling of youth. What are some labels that you’ve heard applied to youth exhibiting these characteristics? (oppositional, defiant, willful, shut down, tuned out, manipulative, closed off, deviant, violent)
In reality, these are symptoms of dysregulation in the brain and may actually be adaptive behaviors in an unsafe environment. Important to avoid pathologizing these behaviors, but rather understand them within the context in which they’ve developed and the purpose that they serve for the youth
Build trusting relationship: listening, empathy, reliability
Fostering community: Community circles; right to pass; shared celebrations, inclusiveness, restorative practices, appreciation of difference
Creating predictability: through structure & explicit rules and expectations; anticipate how changes to routine might impact adolescents experiencing trauma
Embedded Coping strategies: for example, talking with young people about how physical activity can help process anger & sadness; how music allows us to express emotions and how writing can provide release for strong emotions
High expectations communicate that “I believe in you, you are strong and competent, you can do it;” be careful to pair these expectations with compassion, empathy, understanding and support
Collaborate with others who are trauma-informed and bring in appropriate community resources as needed
We know all young people need these things, but there are a few other things we can do for young people who’ve experienced trauma
What do I mean by “distractive and regulating activities?” (“figit boxes” = available to all youth)
playing with clay or koche ball
Coloring or journaling
Grounding yoga, meditation or breathing
Positive self-talk (use of a mantra)
Soothing music
I understand that it may not be feasible for every teacher to know every student’s specific triggers, but if you know the signs to look for that a youth might be experiencing trauma, then someone within the school can build a relationship with that student in which the trauma is acknowledged and understood and coping skills are identified and further developed; classroom teachers can try to reinforce healthy coping by allowing students to use these skills as needed and by incorporating social emotional learning competences into the classroom in general.
Distractive techniques
Change the activity or subject
Offer choices
Take a break or a walk
Use humor
Offer food or drink
ASK: What are some ways we can use our selves and our relationships with the young people to de-escalate the situation?
Collaborate with student in the process of de-escalating the situation; avoid authoritarian approaches such as lecturing or demanding; instead offer choices about how students can proceed and alternatives to negative behavior
Speak slower, softer and with fewer words; listen more and talk less
Be flexible and open minded
Be calm and model self-awareness (of own emotional state, including signs of secondary trauma, compassion fatigue and burnout), self-regulation and self-care
Do not take things personally (if the youth is being disrespectful it is better to address it later when not in crisis)
Self-regulation means recognizing when emotions are getting intense and guiding youth to effective coping, “Let’s talk a minute, breathe deeply, focus on your mantra, talk a walk. Once you’re feeling calmer we can figure out how to move forward/resolve the problem.”
Identifying others’ emotional cues- use storytelling
Linking- “feeling charts” (feeling, thinking, acting)
Assertiveness- language to ask for what you want and ways to appropriately convey what you don’t want; tools to effecively express frustration
Non-judgmental; calm and open-minded
3. Rephrase and restate for clarity; ask clarifying questions as needed
4. Restate the observed behavior and the student’s perspective; state why the behavior is of concern to you
