Child ld Wel elfare are Trauma auma Training aining Toolkit lkit Ver ersi sion on 2.0 Welc lcome! ome! Cabarrus County Schools November 3, 2015 1
Lisa’s 911 Call
Elem emen ent t #1: : Maxim imiz ize e Physica ical l and P d Psychol chologica ogical 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. 3
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 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 4 http://nctsn.org/products/caring-for-children-who-have-experienced-trauma
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 • 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. 5
ders Max axim imiz izin ing g Saf afety: ety: Unde Understan andi ding ng Trau auma a Rem emin inde • 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 6
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 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 7 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. 8
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 9
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. 10
Fa Factors ors that Enhance ce Res esil ilie ienc nce 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 11 http://www.nctsnet.org/resources/topics/juvenile-justice-system
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. 12
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 overwhelming 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. 13
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. 14
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 15 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 Source: U.S. Department of Health and Human Services (DHHS), Administration for Children Families, Child Welfare Information Gateway. (n.d.). Enhancing protective 16 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! Handout: The Invisible Suitcase: Behavioral Challenges of Traumatized Children 17
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