Trauma auma Training aining Toolkit lkit Ver ersi sion on 2.0 - - PowerPoint PPT Presentation

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Child ld Wel elfare are Trauma auma Training aining Toolkit lkit Ver ersi sion

• n 2.0

Welc lcome!

• me!

Cabarrus County Schools November 3, 2015

Lisa’s 911 Call

Elem emen ent t #1: : Maxim imiz ize e Physica ical l and P d Psychol chologica

• gical

l Safet ety y for Chil ildr dren en and d Fa Famil ilie ies Safety is one of the priorities of the child welfare system, but a child and family who have experienced trauma may still feel unsafe even when they are no longer in a dangerous

• situation. Given this, in addition to

ensuring physical safety, it is important to help children and families feel psychologically safe.

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Saf afet ety y an and T d Trau auma

• Children who have experienced trauma may:

– Have valid fears about their own safety or the safety of loved ones – Have difficulty trusting adults to protect them – Be hyperaware of potential threats – Have problems controlling their reactions to perceived threats

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Source: Grillo, C. A., Lott, D. A., & Foster Care Subcommittee of the Child Welfare Committee, National Child Traumatic Stress Network. (2010). Caring for children who have experienced trauma: A workshop for resource parents – Facilitator’s guide. Los Angeles, CA & Durham, NC: National Center for Child Traumatic Stress. Retrieved from http://nctsn.org/products/caring-for-children-who-have-experienced-trauma

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• Children and families who have experienced trauma often

exhibit challenging behaviors and reactions.

• When we label these behaviors as “good” or “bad,” we forget

that an individual’s behavior is reflective of his or her experience.

• Many of the most challenging behaviors are strategies that, in

the past, may have helped them survive in the presence of abusive or neglectful caregivers.

Maxim imiz izin ing g Safety: ety: Und Under erstandi ding g Chil ildr dren en’s s and d Fam amil ilie ies’ Res espo pons nses es

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• Trauma reminders:

– When faced with people, situations, places, or things that remind them of traumatic events, children and parents may experience intense and disturbing feelings tied to the original trauma. – These “trauma reminders” can lead to behaviors that seem out of place, but were appropriate—and perhaps even helpful—at the time of the original traumatic event.

• Reenactment behaviors in children and parents:

– Are familiar and helped them survive in other relationships – “Prove” their negative beliefs and expectations – Help them vent frustration, anger, and anxiety – Give them a sense of mastery over the old traumas

Max axim imiz izin ing g Saf afety: ety: Unde Understan andi ding ng Trau auma a Rem emin inde ders

Pr Promot motin ing g Saf afety ety

• Let children and families know what will happen next.
• Give children control over some aspects of their lives.
• Help children maintain connections.
• Give a safety message.
• Help caregivers manage emotional “hot spots”:

– Food and mealtime – Sleep and bedtime – Physical boundaries

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Source: Grillo, C. A., Lott, D. A., & Foster Care Subcommittee of the Child Welfare Committee, National Child Traumatic Stress Network. (2010). Caring for children who have experienced trauma: A workshop for resource parents – Facilitator’s guide. Los Angeles, CA & Durham, NC: National Center for Child Traumatic Stress. Retrieved from http://nctsn.org/products/caring-for-children-who-have-experienced-trauma

El Element ment #2: 2: Iden entify tify Trau auma ma-Rel Related ated Ne Needs eds of Children ildren an and Fam amilies lies

• One of the first steps in helping trauma-

exposed children and families is to understand how they have been impacted by trauma.

• Trauma-related needs can be identified

through trauma screening and assessment.

• It is important to consider trauma when

making service referrals and service plans.

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Ben enef efit its of Us Usin ing g the e Tool

• Provides a structure for documenting trauma exposure and

severity of traumatic stress reactions

• Provides a developmental perspective on the child’s trauma

history

• Provides a guideline for making referral decisions, rather than

arbitrary decision-making

• May be used to facilitate case discussions between

caseworkers and supervisors and/or professionals in other systems

El Element ment #3: 3: En Enhan hance e Child ild Well ll-Being Being an and Res esilience ilience

• Many children are naturally resilient.
• It is important for the child welfare system to

recognize and build on children’s existing strengths.

• Both individual caseworkers and overall

agency policies should support the continuity of children’s relationships.

• Child welfare staff and agencies should also

ensure that children who have been traumatized have access to evidence-based trauma treatments and services.

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Fa Factors

• rs that Enhance

ce Res esil ilie ienc nce

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Sources: Masten, A. S. (2001). Ordinary magic: Resilience processes in

• development. American Psychologist, 56, 227-238.

National Child Traumatic Stress Network, Juvenile Justice Treatment

• Subcommittee. (in preparation). Think trauma: A training for staff in

juvenile justice residential settings. Will be available from http://www.nctsnet.org/resources/topics/juvenile-justice-system

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Enhance e Chil ild d We Well-Bei eing: g: Supp pport rt and P d Promote mote Po Posit itiv ive e an and S d Stab able e Rel elat ation ionship ships

• Being separated from an attachment figure can be very

stressful for a child.

• Maintaining positive connections enhances psychological

safety and resilience.

• In order to form positive attachments, stability and

permanency are critical.

• Child welfare workers can play a huge role in promoting

positive relationships in children’s lives and helping them maintain connections.

Rec ecap ap: : Enh nhan ance ce Chil ild d We Well-Bei Being ng an and d Res esil ilie ienc nce

• Professionals and caregivers can help children overcome

trauma by enhancing their natural strengths and resilience.

• Positive and stable relationships are vital to children’s ability

to overcome traumatic experiences.

• Children may need assistance to help them cope with
• verwhelming emotions, begin to make sense out of what

happened to them, and express this to others.

• Trauma-informed treatments and services can effectively

reduce trauma impact and enhance child resilience.

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El Element ment #4: 4: En Enhan hance e Fam amily ly Well ll-Being Being an and Res esilience ilience

• Families are a critical part of both

protecting children from harm and enhancing their natural resilience.

• Providing trauma-informed education

and services to parents and other caregivers enhances their protective capacities.

• Child welfare agencies should

recognize that caregivers themselves may have trauma histories.

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Enhance e Fa Famil ily y We Well-Bein eing g and R d Res esil ilie ience ce: : Pr Provid vide e Sup uppo port rt an and d Gui uida danc nce e to Fa Famil ilie ies

• Children experience their world in the context of family

relationships.

• Research has demonstrated that support from their

caregivers is a key factor influencing children’s psychological recovery from traumatic events.1,2

• Providing support and guidance to the child's family and

caregivers is a part of federal goals (CFSR)

• Siblings can experience secondary trauma and also need

support.

1 Laor, N., Wolmer, L., & Cohen, D. J. (2001). Mothers' functioning and children's symptoms 5 years after a SCUD missile attack. American Journal of Psychiatry, 158, 1020-1026.

2 Kliewer, W., Murrelle, L., Mejia, R., Torres de G, Y., & Angold, A. (2001). Exposure to violence against a family member and internalizing symptoms in Colombian

adolescents: The protective effects of family support. Journal of Consulting and Clinical Psychology, 69(6), 971-982. doi: 10.1037/0022-006X.69.6.971

Fa Famil ily y Pr Protecti tective ve Fa Factors tors

• Nurturing and attachment
• Knowledge of parenting and child development
• Parental resilience
• Social connections
• Concrete supports for parents

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Source: U.S. Department of Health and Human Services (DHHS), Administration for Children Families, Child Welfare Information Gateway. (n.d.). Enhancing protective

• factors. Retrieved from http://www.childwelfare.gov/preventing/promoting/protectfactors/

The e Inv nvis isib ible le Sui uitca case

• Children who have experienced trauma often carry negative

beliefs and expectations about themselves, caregivers, and the world based on their past experiences.

• These negative beliefs and expectations often lead to

challenging behaviors, including reenactment behaviors.

• Caregivers can repack the suitcase by providing disconfirming

experiences with positive replacement messages, consistency, and calm responses.

• Caregivers also need support!

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Handout: The Invisible Suitcase: Behavioral Challenges of Traumatized Children

Elem emen ent t #5 - Enh nhan ance ce the e We Well-Bei eing ng an and R d Res esil ilie ienc nce e of Those e Wo Worki king g in in the e Syste tem

• While child welfare staff play an important role

in supporting children, working with people who have experienced abuse, neglect, violence, and other trauma can cause staff to develop secondary traumatic stress reactions.

• Child welfare agencies should collect

information about trauma and secondary trauma experienced by staff, implement strategies and practices that build resilience and help staff manage stress, and address the impact of secondary traumatic stress both on individuals and on the system as a whole.

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Impa pact ct of Wo Workin ing g wit ith Vic ictim ims s of Trau auma ma

• Trauma experienced while working in the role of helper has

been described as: – Compassion fatigue – Secondar ndary y traumat umatic ic stress ress (STS) TS) – Vicarious traumatization

• STS is the stress of helping or wanting to help a person who

has been traumatized.

• Unlike other forms of job “burnout,” STS is precipitated not by

work load and institutional stress but by exposure to clients’ trauma (acute or cumulative).

• STS can disrupt child welfare workers’ lives, feelings,

personal relationships, and overall view of the world.

STS Sig igns ns an and d Symptoms ptoms

• Avoidance (including of certain clients)
• Preoccupation with clients/client stories
• Intrusive thoughts/nightmares/flashbacks
• Arousal symptoms
• Thoughts of violence/revenge
• Feeling estranged/isolated/having no one to talk to
• Feeling trapped, “infected” by trauma, hopeless, inadequate,

depressed

• Having difficulty separating work from personal life

Sound nd familiar? iliar?

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Rel elaxation ation/Se Self lf-Care re Exer erci cise e and d Acti tion

• n Plannin

ing fo g for Essen entia ial l Elem emen ent t 5

• Options:

– Relaxation exercise – Work/Life Balance Plan – Self-Care Inventory

• Action Planning:

– Review the STS resources and strategies in your manual. – Identify three strategies you can use to enhance your own resilience. – Write them on the worksheet in your manual.

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El Element ement #6: 6: Pa Partn tner wi with th Yo Youth th an and Fam amilies lies

• Youth and families should be

given choices and an active voice in decision-making on an individual, agency, and systemic level.

• Youth and family members who

have been in the system have a unique perspective and can provide valuable feedback.

• Partnerships with youth and

families should occur at all levels

• f the organization.

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Fa Famil ily y Partner ershi ship Py Pyram amid id

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Least Participation

Family y Invo volve vement Goal: Involve families at every step of the service delivery and evaluation process. Family y Partn tnership Goal: Partner with families by valuing and utilizing their input on par with the providers within agencies. Families have equal voice and input into processes that may continue after they have left services.

Most Participation

Family y Engagement Goals: Engage Families in services & Improve service utilization.

Elem emen ent t #7: : Partner er wit ith Age gencie ies s and d Syste tems ms That Int nter erac act wit ith Chil ildr dren en an and Fa d Famil ilie ies

• Child welfare agencies need to establish strong

partnerships with other child- and family-serving systems.

• Service providers should develop common

protocols and frameworks.

• Cross-system collaboration enables all helping

professionals to see the child as a whole person, thus preventing potentially competing priorities and messages.

• Collaboration between the child welfare and

mental health systems promotes cohesive care and better outcomes.

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Strat ateg egie ies s for Cross-Syste System m Colla laborati boration

• n
• Cross-training on trauma and its impact
• Jointly developed protocols regarding child and family trauma

and collaborative services that promote resiliency

• Multi-disciplinary teams
• Family team meetings
• Co-location of staff in community “hubs”
• Cross-system assessment tools
• All systems engaged in shared outcomes
• Technology used for information exchange
• Integrated information sharing systems

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Summ mmary ary

• A significant number of children in the child welfare system /

community have been exposed to trauma.

• The experience of trauma affects a child’s behavior,

development, and relationships.

• By understanding how trauma impacts children, and adopting

a trauma-informed lens, all who work with children and their families play a crucial role in mitigating both the short- and long-term effects of trauma.