Region 10 Education Service Center 9723481786 DavidRayRegion10org Overview How to ask questions Overview Treating Traumatic Stress in Children and Adolescents 101 TraumaInformed Interventions ID: 718640
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Trauma Informed Care
David Ray
Region 10 Education Service Center
972.348.1786 David.Ray@Region10.orgSlide2
Overview
How to ask questionsSlide3
Overview
Treating Traumatic Stress in Children and Adolescents
101 Trauma-Informed InterventionsSlide4
Overview
Trauma-Informed Practices With Children and Adolescents by William Steele and Cathy A.
MalchiodiSlide5
What is Trauma?
Trauma happens when an intense experience stuns a person like a bolt out of the blue; it overwhelms the person, leaving him or her altered and disconnected from his body, mind, and spirit. Coping mechanisms are undermined and he feels utterly helpless. It is as if his legs were knocked out from under him. Trauma can also be the result of ongoing fear and nervous tension. Long-term stress responses wear down the person, causing an erosion of health, vitality, and confidence. Slide6
What is Trauma?
Many practitioners confuse trauma and grief reactions in children and adolescents. In brief, grief is an emotional response that accompanies loss; when experiencing a trauma, there is often grieving about what is lost whether it is a significant person, possessions, home, or even the loss of innocence when betrayed by abuse or abandonment. Reactions to grief and trauma are different and it is important to distinguish these reactions in traumatized children and adolescents. Slide7
Grief versus Trauma
GRIEF
TRAUMA
Grief generally does not attack or “disfigure” our identity.
Trauma generally attacks, distorts, and “disfigures” our identity.
In grief,
guilt says, “I wish I would or would not have..”
Trauma guilt
says, “It was my fault. I could have prevented it. It should have been me.”
In grief, dreams
tend to be of the person who died.
In trauma, dreams are about the child himself dying or being hurt.
Generalized
reaction…SADNESS
Generalized reaction…TERROR
Grief reactions can stand alone.
Trauma reactions generally also include grief reactions.
Grief reactions are generally known to the public
and the professional.
Trauma
reactions, especially in children, are largely unknown to the public and often to professional counselors as well.
In grief, pain is
related to the loss.
In trauma,
pain is related to the tremendous terror and an overwhelming sense of powerlessness and fear for safety.
In grief,
a child’s anger is generally not destructive.
In trauma, a child’s anger often becomes assaultive (even after nonviolent
trauma, fighting often increases.Slide8
Types of Trauma
Trauma is often the result of an overwhelming amount of
stress
that exceeds one's ability to cope or integrate the
emotions
involved with that
experience. A traumatic event involves one experience, or repeating events with the sense of being overwhelmed.Psychologically traumatic experiences often involve physical
trauma
that threatens one's survival and sense of security.Slide9
Types of Trauma
Harassment
Extreme Embarrassment
Physical Abuse
Sexual Abuse
Police Brutality
BullyingDomestic ViolenceNatural DisastersMass Violence/WarSlide10
What is Trauma?
While the magnitude of the stressor is clearly an important factor, it does not define trauma. Here the child’s capacity for resilience is paramount. In addition, trauma resides not in the event itself; but rather its effect in the nervous system.Slide11
PTSD
The National Child Traumatic Stress Network (NCTSN) supports the inclusion of a new, more comprehensive PTSD category for children and adolescents called developmental trauma disorder (DTD)Slide12
Trauma
Currently, an emphasis on behavioral control without recognition of interpersonal trauma….and a lack of attention to ameliorating the developmental disruptions that underlie the symptoms
As a result, children may be given a wide range of co-morbid diagnoses that imply that symptoms occur independently from PTSD symptoms. Slide13
History
Chowchilla Kidnapping
July 15, 1976
26 children, ages 5 to 14
Armed blocked highway
Drove for 11 hours
Eventually buried them in a box truck in a quarryWere able to break free after 16 hoursSlide14
Images from ChowchillaSlide15
Images from ChowchillaSlide16
Images from ChowchillaSlide17
Images from ChowchillaSlide18
How Do
Children Experience Trauma?
The basis of single-event trauma is primarily physiological rather than psychological. There is no time to think when facing a threat; therefore our primary responses are instinctual. At the root of the traumatic reaction is a heritage that resides in the oldest and deepest structures of the brain.Slide19
How do Children Experience Trauma?
When the primitive parts of the brain perceive danger, they automatically activate an extraordinary amount of energy. This fathomless survival energy that we all share elicits a pounding heart along with more than 20 other physiological responses designed to prepare us to defend and protect ourselves. Slide20
Physiological Responses
Redirection of blood flow away from the digestive and skin organs and into the large motor muscles of flight
Rapid respiration
Decrease in normal output of saliva
Blood-clotting ability increases
Verbal ability decreases
Excited and Stiff MusclesDistorted Sense of TimeSlide21
Physiological Responses
When faced with inescapable threat or prolonged stress, certain muscles collapse in fear as the body shuts down in an overwhelmed frozen state as the last-ditch default response.
The body may look inert in this state of freeze/collapse, those physiological mechanisms that prepare the body to escape may still be prepared for “full charge.”Slide22
Physiological Responses
If these same children had been cheetah cubs, they wouldn’t need our help. After withstanding and terrifying exposure to danger (such as a hunting lion), the frisky pack mates might be found playing, roughhousing and shaking it off. Documentaries have filmed this reenactment mirroring the drama they witnessed by playing through the actions their parents took to battle off the intruder.
Excess adrenaline, cortisol, and other chemical and hormonal releases in the wake of survival get channeled into use. Slide23
Physiological Responses
Children often “re-see” their trauma during leisure times, when they are resting, daydreaming, or trying to fall asleep, rather than in nightmares or the characteristic flashback of adult PTSD. Slide24
Physiological Responses
The effects of emotional trauma in children can last for decades, influencing the child’s development of trust, initiative, interpersonal relations, self-esteem, and impulse control. Slide25
Belief Systems of Children Who Have Experienced Trauma
I’m not safe
People want to hurt me
People cannot be trusted
The world is dangerous
If I’m in danger, no one will help
I’m not good enough for people to care about meIt will never get betterSlide26
What is Trauma Informed Care
Trauma-informed care is an approach to engaging people with histories of trauma that recognizes the presence of trauma symptoms and acknowledges the role that trauma has played in their lives.
Its presence brings to light that traditional service delivery may actually exacerbate traumatized individuals and that a comprehensive approach addressing the individual, environment, and service providers is fundamental to traum
a recovery. Slide27
Interventions Include
Art Therapy
Cognitive Behavioral Therapy
Emotionally Focused Therapy
Psychodrama
Somatic Experiencing and Movement TherapiesSlide28
What does that mean for the classroom?
Relationships
“Overall, caring human relationships buffer the effects of stressful events and literally support the neural networks involved in bonding, attachment, attunement, social interactions, and affiliation
.”
Relationships are the intervention
Early stages of relationships are not corrective
AttachmentThe quality of early attachment experiences is widely accepted to be the most important influence on psychosocial development.
Early childhood attachment determines whether a child’s brain, body, sense of self, capacity for relationships, and conscience all develop properly.Slide29
What does that mean for the classroom
?
Importance
What I am doing has meaning
Could be leisure
Safety
IdeasPropertyBodyEgoEmbarrassmentSlide30
What does that mean for the classroom/campus?
That teacher is my teacher and he/she cares for me and wants to see me everyday.
That class is my class and I am a meaningful member of the class.
This school is my school and I am a meaningful member.
My school is safe and predictable and will help me succeed. Slide31
What does that mean for the classroom/campus?
Positive Behavior Supports and Interventions
Dr. Randy
Sprick
– Safe and Civil Schools, CHAMPS
Check with your ESCResiliency TrainingChristian Moore – The Resilience BreakthroughCheck with your ESC 2016-17 school yearSlide32
What does that mean for the classroom/campus?
Be Curious, Not AnalyticalSlide33
An Anecdote
John
Seita
, Western Michigan State University
Seita
Scholars Program