Trauma can interfere with the development of healthy coping skills. This can prevent children from interacting in an appropriate way with peers, teachers, and family. Those that have been bullied can also become bullies because of the same principal.

1. Second Annual Bullying Prevention
Conference
December 14, 2012
Presented by LSU Baton Rouge

2. CARE for the Roots and
the Tree Will Bloom

3. Effective Steps to Counteract Trauma, Bullying
and Violence

4. k.seifert@espsmd.com
http://preventbullyingnow.info
http://drkathyseifert.com
Dr. Kathryn
Seifert

5. • Bullies have been bullied or traumatized
• They have learned to be bullies from a
role model. To change a bully, change the
role model (teachers, parents, & School
climate)
• Multi-disciplinary Teams for the most
difficult cases include teachers, mental
health, counselors administrators, and
law enforcement
Major Concepts

6. • Primary Prevention – everyone
• School Climate – Respect for all and talking through conflicts
• Less Severe Problems - Teachers
• Teaching Social Skills – Olweus, character counts
• Moderate Problems - Behavior Coaches
• Setting limits, positive reinforcement, Behavior
management
• PBIS
• Severe Problems – Mental Health Referral
• Very Severe Problems - Law Enforcement and/or mental
health
Interventions Depend on the
Severity of Problems

8. • Some bullies have rather moderate
problems that are fairly easily
remedied with traditional methods.
• Some Bullies have very serious
problems that are much more
difficult to resolve
• Identification, assessment and
treatment for these two groups are
different.
There are little b bullies and There
are BIG B Bullies.

9. The Severity of the Problems of a
Youth that Bullies Relate to:
• Severity and age at
which they experienced
trauma
• Prior Bullying
• Level of Aggression
• Family and school
experiences
• Types of interventions

10. Let’s Start at the
Beginning

11. Babies Are Born Innocent and Helpless
and Need Adults to Take Care of Them

12. But, what if they grow
up in
 Violent,
abusive, or
neglectful
homes?

13. Trauma
Fight/Flight
/Freeze
Numb –
unable to
act
Frontal
Cortex Not
in Use
New
Stressor -
High
Arousal -
Excitability
Hyper-
Vigilant –
Poor
executive
function
In the days of
dinosaurs this
reaction to stress
was a survival
strategy. And led
to safety.

14. Traumatized children may fight
 Be angry,
hostile,
defiant and
aggressive

15. The Under-Achiever
Or they may become good at
Fleeing – Running Away from
their Problems:

16. What do they learn?
 To withdraw,
hide or make
themselves
small
(Freeze)

17. Development of coping skills may be so
focused on fight, flight, or freeze,
• That development of more
complex skills do not progress
as well, such as:
• Problem solving
• Developing trust, perspective
taking, and relating well to
others
• Emotional regulation
• Brain development
• Self-soothing and calming down
• Self monitoring to change
behavior.

18. Trauma also affects the brain and
brain/body communication

19. • Brain still developing throughout childhood.
• Make a fist with thumb sticking down – Thumb is
brain stem, inside of fist is limbic system
(emotions), fingers are cerebral cortex or thinking
part of brain.
• The brain develops from most primitive to most
complex.
• Over proliferation followed by use it or loose it
trimming.
• Amygdala – emotional regulation – may be smaller
and less effective
• Brain development may be delayed
• Cortisol may be in over abundance causing a
constant state of arousal
Problems caused by trauma

20. This attachment may be
damaged by early
trauma
Attachment is the
heart to heart
connection
between infants
and their
caregivers

21. Close proximity of caregiver for protection and
meeting needs of child (Bowlby)
Supports healthy development in every area
Is the basis for developing trust, reciprocity, and
healthy relationships throughout the lifespan
Supports healthy brain development
Teaches self-soothing and how to build
relationships through attunement
Is the basis for moral development (Kohlberg,
1969)
Creates safe haven for exploring the world(Mary
Ainsworth)
Necessary for the development of the amygdala
and limbic system for emotional regulation and for
the development of mirror neurons to create
empathy
8 Vital Functions of Secure Attachment

22. Secure Attachment
Baby has
needs
Baby cries
to get
Mom’s
attention
Mom
attends to
his needs
He feels
safe,
relaxed, &
happy
He is good,
his mom is
good, the
world is
good.
arousal
satisfaction

23. • Positive view of
self, others and
the world
• Development of
skills is
appropriate for
age and IQ
• Emotions well
modulated after
age 5
Secure attachment = Positive
Development of self

24. • Effective coping skills and improved behavioral
regulation by age 7
• Able to form trusting reciprocal relationships after age
10
• Loving and respectful relationships with parents and
others
• Has empathy and compassion after age 10 (A chronic
bully before and after age 10, may not have developed
empathy for others.)
• Is academically successful in school to the best of his
ability and is behaviorally well adapted. Look for
bullies among those frequently suspended from school
across grades..
Healthy Attachment

25. Disrupted Attachment –
disorganized/Dismissive/Disinhibited Type
Baby has
needs
Baby Cries
to get
Mom’s
Attention
Mom rarely
comes or
attends to
his needs
He cries &
cries until
he stops
crying
No one
can be
trusted
I must take
care of
myself
I must have
Power

26. • Behavior problems that begin in
adolescence, often end in adolescence if
routine interventions are used. (Easier to
solve)
• Chronic Behavior problems that begin in
elementary school may signal a life long
trajectory of aggression toward others and
need a different type, intensity, and length
of intervention.
Trauma and attachment Problems at
ages 0 – 3 can result in a Life-Long
Trajectory of Interpersonal Aggression

27. Why is that?

28. • Recognizing that an individual has a mind and that
others have a mind, each with a point of
view, which can differ.
• Basis for perspective taking, interpreting intention
of others, and empathy.
• Certain brain functions and social experiences are
necessary for an individual to develop a theory of
mind.
• Autistic and children maltreated in early childhood
either do not have or have a poorly developed or
distorted theory of mind.
• This does not allow the adequate development of
empathy, perspective taking, understanding
another’s intentions, or reciprocity.
Theory of Mind

29. • Toddlers do not have the social
skills to get what they want
through negotiation.
• They take what they want
• They can be quite physically
aggressive – pushing, pulling hair,
grabbing
• Tremblay et al.
Ages 2 ½ to 3 ½

30. • For those that have adults teach them
other ways to get their needs met,
aggression goes down to zero and
stays there throughout the school
years.
• For those that do not have adults
teach them other ways to get their
needs met, aggression remains –
sometimes for a lifetime
3 ½ to 5

31. • Skill Development
• Interpersonal Relatedness
• Self Concept
• Self Management
• Theory of Mind
• Emotional Regulation
• Development of Pro-social values
• Brain Development
• Family Cohesiveness and relationships
Additionally, When Attachment Bonds are
disrupted, There can be problems with

32. • Negative view of self, others and
the world
• Development of skills lags behind
age and IQ
• Emotions not well regulated after
age 5
• Learning Problems
Disrupted attachment patterns -
self

33. Complex PTSD (Courtois)/Developmental Trauma Disorder (Van
der Kolk)
• The victim is psychologically and physically immature and
dependent on others.
• His or her development is often seriously compromised by
repetitive abuse and inadequate response at the hands of
family members or others on whom he or she relies for safety and
protection.
• Symptoms include dysregulation, severe problems with
interpersonal relatedness, and ineffective general functioning

34. 3 Major Outcomes for Early Trauma
• Building strengths from overcoming the trauma
• When an adult helps a child overcome trauma and teaches skills
• Becoming bullies or a violent individual
• When no one attempts to help child overcome trauma and teach
skills
Becoming withdrawn, anxious and depressed.
When no one helps the child recover from trauma
All maltreated children should be assessed for family
therapy and skill building

35. DISORDERS OF DYSREGULATION IN CHILDHOOD AND
THEIR RELATIONSHIP TO TRAUMA
 Conduct Disorder
 Aggression
 Destroys property
 Deceitfulness
 Violates rules
 Oppositional Defiant Disorder
 Angry/irritable
 Defiant
 Vindictive
 Trauma is the likely the major source of the above disorders
(Seifert, 2012; Greewald, 2002; Frick & Silverthorn, 2001; Rhee et
al., 2001; van den Oord, Verhulst, & Boomsma, 1996; Waldman
et al., 1998 and
http://www.aacap.org/cs/root/facts_for_families/conduct_disord
er

37. RELATIONSHIP HEALTH
Severely
Disturbed
Attachment
Patterns
Primarily
Highly
Conflicted
Relationships
Primarily
Positive
Interpersonal
Relationships
Altruistic
Relationships

38. BULLYING

39. Types of Bullies
Bully
• Sadistic, Narcissistic – Purposeful. Lacks
empathy & needs to feel omnipotent. Deep
seated problem requiring intensive services
– Needs thorough Assessment and intensive
treatment (BIG B Bully)
• Very Serious Problems

40. • Follower. Responds to overall culture
of the group with whom he is
surrounded. Needs supportive
counseling, guidance and social
skills. Can be led toward or away
from Bullying – Olweus Bullying
Program (Adolescents trying to fit into
a group. Has to do with VALUES)
Imitative Bully

41. • Reacts to the situation. Difficulty
restraining himself. May have been
bullied. Evaluate for Trauma, family
problems, ADHD and treat (Could be
a culture/Values Issue)
Impulsive bully

42. • Watches and enjoys bullying and
encourages the bully. Needs
assessment for treatment options
(May be a BIG B Bully)
Bully by proxy

43. • Bystander – stands by does nothing
to help victim either because of fear,
uncertainty, or mixed feelings
(Universal
Bystander

44. Any Type of Bully Can be An Outgrowth of
Past Trauma, but most likely the Sadistic
and Impulsive Types (Big B)
• child abuse and neglect
• Exposure to domestic violence
• failure to teach alternative ways to get one’s
needs met
• violent role models

45. • Prevents Victim from becoming a
bully
• Yellowribbon.org – It’s OK to ask
for Help
• Mental Health Referral
Help the Victim

46. Important Bullying Facts
Bullying is serious and should never be ignored.
Bullying is not a normal part of growing up.
Suspension is not an adequate answer.
Bullying is an adult problem to solve. Children cannot solve a
bullying problem alone.
Parents of the bully need to be involved in solving the problem.
Stopping some types of bullying is about teaching respect for
diversity and teaching social skills.
Some bullies have deep-seated problems that will take
significant treatment, some do not. teachers and counselors
need to know which is which because interventions will be
different.
Most school shooters felt they were bullied and ostracized by
another group of youth. Their attacks were often retribution
toward the group that bullied them.

47. Bullying Approaches
For those that do not have severe
,deep seated problems
Olweus Bullying Program -
http://www.violencepreventionwork
s.org/public/olweus_bullying_preve
ntion_program.page
Operation Respect -
http://operationrespect.org/
Character Counts -
http://charactercounts.org/
School based mental health
http://yellowribbon.org
When you are not sure :
Assessment of severity of problems,
dangerousness and appropriate
interventions

48. • Severe problems
• chronic problems
• multiple problems
• Past aggression
• Problems began in elementary
school
When is the problem more
serious?

49. Warning Signs
Youth at Risk for Chronic Violence have
multiple problems, but may be different
for girls and boys
More Problems = Greater Risk for Chronic
Aggression
Boys
Past assaults on others between the ages of 5
an 12
Chronic School Behavior Problems
Oppositional to authority
Not doing well in school
Fire setting
Childhood maltreatment by a caregiver
Lacks remorse
Anger management problems

50. Violence &
School
Shooters

51. From Bullying to Violence in Schools
Bullying can lead to violence in
our schools and School
Shootings
Most school shooters felt they
were bullied by others
Which youth are at high risk for
extreme violence?
What are the warning signs?
Which ones need intensive
interventions to prevent future
violence?

52. Warning Signs for Girls Who are Violent
Past Assaults
Harms animals
Delinquency
Childhood maltreatment
Substance Abuse (teens
only)
Anger management
problems
Lacks remorse
Poor problem solving skills
Bullying Behavior
Delinquent peer group
Chronic School Behavior
Problems

53. Assessments to Determine the Best
Intervention

54. One Size Does
Not Fit All

55. • Problems and Strengths
• Complexity or severity of
problems
• Levels and types of
interventions needed
• Developmental level of
coping skills
• Functioning of family
What an Assessment Should Tell You

56. Problems and Strengths

57. Problems & Strengths
• Problems
• School difficulties
• Bullying
• History of aggressive
acting out
• Problems began
before adolescence
• Parents not
supportive of
working with school
to find solution
• Strengths
• Does well in school
• Gets along well wit
peers
• Respectful of
authority
• Corrects behavior
when requested
• No past aggression
• No past delinquency
• Talented in ________

58. Charles Manson (Disinhibited/
disorganized/dismissive attachment type
and below average relationship health)
• Mother was a teenager and an alcoholic
• She severely neglected Charles. He
ran the streets from a very young age
• She once sold him for a pitcher of beer
• He was delinquent and a bully
• Spent most of his teenage years in
institutions
• Raped a boy in one of the institutions
• Drug user, never held a job
• “Family” responsible for Tate &
LaBianca Murders

59. Mother Teresa (Secure Attachment type and
above average relationship health)
• Agnes was born in Albania (Bosnia).
• Father was in Albania independence
movement. Likely poisoned by
opposition political group when
Agnes was 8 yo.
• Parents very supportive of children,
deeply religious, gave to the poor
• Financially and emotionally
devastated when father died.
• Agnes was good student, active in
church, and no behavioral problems.
• She was neither a bully, nor bullied
• Mother became entrepreneur and
support family. Still gave to the poor
and devoted to children.
• Agnes became a nun when she was
18 years old.

60. Nelson Mandela
• His nickname as a child was
troublemaker
• Lost his father when he was 9
• Regent Jongintaba became his
guardian
• He was very good in school
• Was bullied as a teen in Boarding
School
• Led ANC’s 1952 Defiance Campaign
against apartheid
• Led the ANC’s Bombing and
sabotage campaign
• Imprisoned for 27 years
• Became first elected president of
the new Republic of South Africa in
1995

61. 0
1
2
3
4
5
6
Non Violent
Altruistic
Violent
Violent
All 3 groups had losses &
trauma.

62. Violent Group
Non-Violent and Altruistic Groups
had nurturing families, positive
school experience and activities
and helped others

63. Complexity or severity of problems

64. • Mild
• Less than 4 months duration & easily
corrected. Counseling or skill group 1 a
week or every other week, 6 months or
less.
• Moderate
• A year in duration & at risk for negative
consequences. Weekly, may need to bring
in family, skill groups
• Severe and Chronic
• Lasting more than a year, started before
age 13, multiple problems, few
resources, at risk for placement, need to
involve family
Severity and Complexity

65. Levels and types of interventions
needed

66. Both Bullies
and those
being Bullied
Need
Assessment for
Services

67. • Mild
• Counseling or skill group 1 a week or every
other week, 6 months or less. Supportive or
relationship counseling I likely to be sufficient.
• Moderate
• Supportive counseling not sufficient.
Weekly, may need to bring in family, skill
groups for 1 year. Developmental approaches
may be needed for some.
• Severe and Chronic
• Supportive counseling not sufficient.
Individual, family and group; intensive (multiple
times per week); need to involve family;
placement may be needed. Services needed for
more than 1 year. Developmental approaches
likely are needed.
Levels of Intervention

68. CARE2 Problem Complexity Score
o Uses all items on the CARE2
o Clinical, historical, dynamic, and those that
predict violence
o Gives a score that can track progress
o Gives EBP Treatment plan
o Allows agency to use more expensive
treatment for most chronic and severe cases
o Can also use Strengths score
o Can change treatment plan if youth is not
improving

69. CARE2 – Violence
o 4 NORMS
o Male/female
o Pre-teen/Teen
o Mark all that apply (Clinical and Risk
Items)
o Items with scores are added and
resiliency scores subtracted
o risk scale are statistically derived on a
sample of 1000+ youth and studies of
subsets
o Evidence based intervention plans

70. Skill Development

71. • Clinical Judgment no better than
Chance
• SAVRY – Randy Borum – U. of S.
FL., primarily for violence. Excellent
tool.
• LS-CMI – Andrews. Case management
tool primarily for delinquency. Found
no gender differences.
• PCL-YV. Adelle Forth & Robert Hare.
Measures Psychopathy. Do not use for
girls
Violence Risk Assessments

72. Trauma Negatively Affects Moral Development, Kohlberg, 1969
Can be blocked by Trauma
Can be blocked by Trauma
Can be blocked by Trauma

73. Development of Childhood Aggression
All children below the age of 3 are
aggressive
When parents teach children
alternative ways to get their
needs met, they stop being
aggressive when they enter
kindergarten or 1st grade
When no one takes on the job of
teaching alternatives to
aggression, the children remain
aggressive after they enter
school.
This is a red flag that family
intervention is needed.

74. More in depth assessments and interventions are
needed for any school age aggressive child if any of the
following are true
• Low level of coping skills?
• Child’s behavior not appropriate
in multiple settings
• Parents do not respond to
requests from school or
therapist to help problem solve.
• The child appears to be
physically neglected?
• The Child appears to be
hyperactive, depressed, irritable,
or unable to focus most of the
time?

75. The Marshmallow Experiment

76. Behavioral Objective Sequence
Sheldon Braaten

77. The Behavioral Objective
Sequence
• By Sheldon Braatan
• A developmentally sequenced group of
skills in 6 Domains.
• Age is not the determiner of skill level
• Youth must learn skills in appropriate
developmental sequence.
• Find out at what level they have
mastered skills (can do it 90% of the
time without prompting)

78. Adaptive Skills
Responds in a developmentally appropriate
manner to rules and expectations
AND
Changes those responses as the circumstances
change
Example
I expect a __ year old to walk into the
counseling office and be able hold a
conversation with the counselor AND when
the format is changed to group therapy, the
youth is able to adapt to the different format
and relate to peers in the group, not just
counselor.

79. Adaptive: Responds appropriately to
routine and new expectations
respond independently to materials for amusement
appear alert and able to focus attention
bring no weapons to school
use amusement materials appropriately
wait for turn without physical intervention
use and return equipment without abuse
accept positive physical contact
touch others in appropriate ways
refrain from stealing
respond when angry without hitting
recognize and show regard for possessions
accept verbal cue for removal from a situation
respond when angry without abuse of property
respond appropriately to substitute
respond when angry without threats
walk to timeout without being moved by an adult
work or play without disrupting others
refrain from inappropriate behavior when others
lose control
respond to provocation with self-control
respond when angry with self-removal

80. Self-Management Skills
Responds appropriately to challenging
experiences with self-control in order to
achieve success
Example
Gets upset with brother because he broke
something that belonged to client.
Client is able to use alternative strategies
to manage self and situation and not
harm brother, ie. ask for help

81. Communication
• Ability to share with and
receive information from other
people to meet a need or affect
another person in a positive
way.
• Example:
• You need to turn in your book
report by Friday
• Tell him you would like a turn
with the _______.

82. Interpersonal Behaviors
• Interacting with others in social and
task situations in ways that meet
personal and interdependence needs
and contribute to a sense of
belonging
• Example:
• Can participate in group
• Can give and accept positive or
negative feedback

83. Task Behaviors
• Student engages in task or
activity with or without
assistance
• Example:
• Finish a homework independently
• Can set the table without
assistance

84. Personal Behaviors
• Student engages in a counseling
dialogue with a helping
person, permitting adult to help
resolve issues or solve problems or
build self esteem.
• Example:
• Can ask for help from an adult
when stressed
• Can discuss problems with
counselor and generate possible
solutions

85. Level 3 (skills typically mastered
during preschool years):
Focus: Self; Significance; Success
Issues: Trust; Pleasure; Security;
Support
Interventions: Routines; Repetitions;
Modeling; Rewards; Limit Setting;
Consistent and Planned
Consequences; Continuous
Supervision
Adult Role: “Benevolent Dictator”

86. Level 2 (skills typically mastered during
elementary years):
Focus: Group membership; Competence;
Sensitivity to Others; Awareness of Values;
Communication Skills
Issues: Applying Skills in Groups; Balancing
Personal and Group Needs; Responding to New
Settings and People; Managing Movement
Interventions: Routines; Repetitions; Verbal
Rewards; Limit Setting with Expanded Choices;
Consistency with Group Consequences; Natural
and Logical Consequences
Adult Role: “Group Leader”

87. Level 1 (skills typically mastered during
adolescence and early adulthood):
Focus: Belonging; Cooperation; Personal
“Power,” Individuation
Issues: Applying Skills in New Situations;
Expanding and Reinforcing Competencies;
Transitions to New Environments
Interventions: “Normal” Expectations; Social
Rewards; Expanded Choices; Group
Problem Solving; Self Selected Goals
Adult Role: “Guide/Facilitator”

88. Functioning of family

89. • Parenting Skills
• Communication Skills
• Conflict Resolution Skills
• Acceptance of Diversity
• Mental Illness
• Substance Abuse
• Homelessness
Assess Family Functioning

90. Interventions

91. General Interventions
Try correcting the behavior
first. Use behavior
management and contracts.
Teach the method to parents to
use, as well.
Teach respect for differences
If children respond, it is likely
not a deep seated problem.

92. • School wide education campaign
• It’s OK to Ask for Help
http://Yelllowribbon.org

93. Severe Behavior Problems
Remain
If child is still:
Frequently Assaultive
Has chronic, moderate to severe
behavior problems
Has history of childhood maltreatment
His/her behavior is out of control and
cannot be corrected
Child lacks respect for authority
Assessment is needed to determine
severity of problems and treatment
and if it is a family problem.
Refer for Mental Health
Evaluation

94. Assess Youth For:
• Level of strengths
and problems
• Developmental
Level
• Types of
interventions
needed
• Family Functioning

95. • Right Intervention for Right Youth
• Interventions for needs of youth and family
• More structure
• Parent education and therapy
• Behavioral Objective Sequence
• More intensive services
• Services for years, rather than months
• Case Management
• Coordination of multiple agencies
School Based Mental Health

96. • Early childhood trauma can interfere with the
development of important skills
• Those that receive appropriate support and assistance
can grow up to be healthy
• Those that do not receive what they need can become
bullies and violent
• Appropriate treatment can change behavior and skill
developmental level
• Adolescence specific and life long trajectory aggression
toward others are very different and require different
treatment.
• School wide skill building programs are only appropriate
for less severe forms of bullying and aggression
• More severe and complex problems require more
intensive and a broader spectrum of services.
Summary

97. Elephant Story