MANAGING A TRAUMAINFORMED COURTROOM Hon Marcia Hirsch Presiding Judge Queens Treatment Courts Research Provided by Dr Pamela Linden Assistant Professor Stony Brook University and Dr Shelly Cohen Stony Brook Research amp Evaluation Consulting ID: 761523
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MANAGING A TRAUMA-INFORMED COURTROOM Hon. Marcia Hirsch, Presiding Judge, Queens Treatment CourtsResearch Provided by; Dr. Pamela Linden, Assistant Professor, Stony Brook University andDr. Shelly Cohen, Stony Brook Research & Evaluation Consulting 2014 Drug Court Institute Boise, Idaho August 4 th , 2014
Trauma Project Collaborators Treatment Court TeamsCourt staff from five felony treatment courts in Queens (QTC, QDWI, QMHC, QVTC, QDDC)Queens District Attorney’s OfficeDefense Bar (Legal Aid, QLA, Private Attorneys) Queens TASC NYS Departments of Probation and Education & US Department of Veterans Affairs Treatment Agencies Samaritan Village, Inc Counseling Services of the Eastern District of New York Elmcor Youth and Adult Activities Program Evaluators Stony Brook Research & Evaluation Consulting, LLC *Special Thanks to Policy Research Associates
Queens Trauma Project (QTP) Funded by grant from the Center for Substance Abuse Treatment (CSAT) for three years from October 1, 2010 through September 30, 2013Goals of QTPProvide enhanced screening and assessment of all participants in the five felony treatment courts in Queens County, NY (approximately 200/year) Provide trauma specific treatment services to participants that are identified as potentially benefitting from these services (approximately 40/year) Conduct evaluation of fidelity of implementation of program activities and success of activities in achieving intended outcomes
Trauma Informed Care WHY?WHO?WHAT?
Why do we learn about trauma? Develop understanding Increase awareness Recognize signs Learn how to respond
Goal: Trauma Informed Responses Increase safety Reduce recidivismPromote recovery (SAMHSA)
Traumatic Events: Physical abuseLossCombat or victim of warCommunity traumaSexual abuseDomestic violenceWitness violence or other traumatic eventHistorical trauma Terrorism Natural Disaster (SAMHSA)
Trauma Is: An event, experience, or effect Sudden event or long standing abuse(can be in the past or present)The event is terrifying, threatening, and overwhelming Impact is pervasiveIs shapes the world view of the participantIndividualized experiences Many people cope or heal while others get stuck
Demographic Characteristics of Participants (N=440, plea dates 10/1/10 -- 9/30/12) Court QTC (n=199) QDWI (n=113) QMHC (n=71) QVTC (n=36) QDDC (n=21) Mean Age (yrs) 28 37 37 41 35 % white % black % Hispanic % Asian 36% 33% 43% 4% 18% 19% 49% 14% 40% 40% 18% 3% 19% 65% 15% 0% 35% 30% 35% 0% % male 87% 92% 79% 94% 81% % Employed F/T ( Employed/school) 26% (55%) 60% (78%) 11% (38%) 28% (46%) 20% (40%) % HS grad/ GED 68% 75% 63% 100% 62% % Priv Attorney 48% 71% 20% 36% 14% % married % divorced % single 14% 7% 78% 45% 15% 40% 16% 26% 58% 28% 40% 32% 14% 14% 71% % US Citizen 99% 68% 82% 92% 91%
Other Characteristics of Participants (N=440, plea dates 10/1/10 -- 9/30/12) Court QTC (n=199) QDWI (n=113) QMHC (n=71) QVTC (n=36) QDDC (n=21) Drug of Choice Alcohol Cocaine/Crack Heroin Marijuana Other 2 15 11 53 19 92 2 0 6 0 Data not available 33 25 8 21 13 11 27 32 11 19 CAGE (% 2+) 13% 26% “ 38% 44% % Prior AOD treatment 28% 27% “ 44% 76% % Ever abused 9% 5% “ 40% 29% % Ever homeless 10% 2% “ 43% 43% Criminal Charge % Drug Sale % Drug Possession % DWI % Other 30 64 0 6 0 2 97 2 13 9 1 77 19 17 22 42 29 33 0 38
Trauma Instruments Adverse Childhood Experiences (ACE) N=27074% reported score of 0-213 % reported score of 3-413% reported score of 5 or moreTrauma Symptom Checklist-40 (TSC-40) N=249 63% reported score of 0-30 20% reported score of 16-30 18% reported score of 31-97 PTSD Checklist-Civilian Version (PCL-C) N=50 32% reported score of 17-22 (no clinical concern) 28% reported score of 23-31 (symptoms of some clinical concern) 40% reported score of 32-57 (likely presence of PTSD) Impact of Events Scale (IES) N=45 76% reported score of 0-23 (no clinical concern) 13% reported score of 24-32 (symptoms of some clinical concern) 11% reported score of 33-76 (likely presence of PTSD) Trauma History Screen (THS ) Not formally scored , but used to gather more details about traumatic events Combat Exposure Scale (CES) N=11 Administered only to Veterans
Trauma in Veterans(N=36) Combat Exposure Scale (n=11)9% moderate-heavy55% light-moderate36% light-noneAdverse Childhood Experiences (n=25) 36% ACE score of 5 or more items endorsed 20% ACE score of 3-4 items endorsed 44% ACE score of 0-2 items endorsed Current Trauma Symptoms 100% indicate likely presence of PTSD on PCL-C (n=5) 50% score 31+ on TSC-40 (n=24)
Program Status and Trauma
New Arrest or Warrant and Trauma
Phase Advancement and Trauma(median number of days)
Types of Reported Trauma(n = 39) Loss of close family member through death (16) or separation (2)Military Combat experience (3)Sexual abuse as a child or adult (5)Auto accident (4)Work accident with injury (1) Witness family violence (4) Natural Disaster/Hurricane (1) Witness stranger’s death (1) Assault (2)
Treatment Interventions Three (3) Trauma Case Managers hired in three Queens County treatment agencies and trained in three trauma treatment group models:Trauma, Addictions, Mental Health and Recovery (TAMAR) Seeking SafetyHelping Men Recover
TAMAR The TAMAR Program is designed to educate and treat those who have a history of physical and/or sexual abuse and a recent treatment history for a mental health condition as well as an alcohol or drug use or abuse disorder. Structured, manualized 15-week intervention combining psycho-educational approaches with expressive therapies
Seeking Safety Offers coping skills to help clients attain greater safety in their livesHighly flexible and can be used for group or individual format; women, men, and adolescents; all levels of care (e.g., outpatient, inpatient, residential); all types of trauma and substances; and any clinician.25 treatment topics, each representing a safe coping skill relevant to both PTSD and SUD.Used broadly with clients who need improved coping skills; they do not have to meet criteria for PTSD and substance abuse as the skills can be generalized.
Helping Men Recover Helping Men Recover integrates a theory of addiction, a theory of trauma, and a theory of male psychosocial development. Program materials consist of a facilitator manual and a participant workbook 18 sessions in four modules: Module A: Self Module B: Relationships Module C: Sexuality Module D: Spirituality
Participant Feedback “Trauma services saved my life.” “I am very grateful for this experience. Though it has been difficult at times, I know it will better my life and my future.” “I was lost before and all this experience helped me improve my life and emotional issues that has led me to the wrong paths.” “I recommend it to those who really need it and would benefit from it. I enjoyed it.”
Recovery A process of change through which individuals improve their health and wellness, live a self-directed life and strive to reach their full potential.
Questions?Please contact: Hon. Marcia Hirsch, Presiding Judgemhirsch@nycourts.gov Dr. Shelly Cohen, Program Evaluator, Stony Brook Research & Evaluation Consulting, LLC scohen@notes.cc.sunysb.edu Dr. Pamela Linden, Evaluation Consultant , Stony Brook Research & Evaluation Consulting, LLC Pamela.Linden@stonybrook.edu