Trauma Informed Practices: The Attachment, Self-Regulation and Competency (ARC) Model: Adolescents in group care Lise Milne, MSW, PhD (c.) Dr. Delphine Collin-Vézina ISPCAN symposia October 2, 2017

ARC: A System-Based Approach to Trauma Handful of trauma- informed interventions Few present multi- systemic design and implementation among direct-care staff Targets the 3 core RESILIENCY domains: Attachment, Self- Regulation, and Competency

Why the need for a trauma-informed training for group home educators? Two studies with Canadian adolescents in residential/group care Numerous US and other international studies with similar findings Type of Abuse Montreal1 Toronto2 Sexual abuse 38% 34% Physical abuse 62% 55% Emotional abuse 68% 64% Physical neglect 57% Emotional neglect 59% 74% Compounded maltreatment: 83% reported 1+ types 40%-44% reported 4+ types 19%-23% reported ALL 5 TYPES 1Collin-Vezina, Coleman, Milne, Sell, & Daigneault (2011) 2Milne, L. (2017). Current PhD research (Maltreatment and Adolescent Pathways Study)

Why the need for a trauma-informed training for group home educators? Other potentially traumatic events: separation from caregiver, peers exposure to community, dating, and intimate partner violence marginalizing home conditions high clinical levels of anxiety, depression, anger, PTS, dissociation, sexual concerns, substance misuse, self- harm, delinquency dose: response - #traumatic events: symptom levels CPS: **Group home educators feeling frustrated, unable to manage such complex presentations by youth

Resilience Cicchetti (2012) “...resilience is a dynamic developmental process encompassing the attainment of positive adaptation despite exposure to significant threat, severe adversity, or trauma that typically constitute major assaults on the processes underlying biological and psychological development.” Boris Cyrulnik (2011) (translated from French): “Resilience isn’t a success story at all, it’s the story of the child who is pushed towards death and fights to invent a strategy to come back to life.”

Ecological Model Resilience Characteristics of the abuse (duration, severity, cumulative effect) Individual factors (temperament, coping strategies) Family factors (family relationships, living conditions) Social and cultural factors (intervention programs) Characteristics of the abuse (duration, severity, cumulative effect) Ecological Model Individual factors (temperament, coping strategies) Family factors (family relationships, living conditions) Social and cultural factors (intervention programs)

1 3 2 The ARC Model evidence- and practice-informed treatment Attachment 3 Competency 2 Self-Regulation evidence- and practice-informed treatment grounded in trauma theory, attachment, and child development works with the youth-in-context current adaptive responses linked to experiences interventions within immediate environment

1 Traumatized youth may… perceive the world as dangerous Attachment perceive the world as dangerous expect to be hurt in relationships be detached, unresponsive or resistant to comforting lack confidence in themselves to succeed in the social world be overly dependent on others; show indiscriminate sociability

2 Traumatized youth may… Self-Regulation have limited vocabulary for identifying emotions be disconnected from emotional experiences few/no adaptive strategies to express & modulate difficult or intense emotions have too much/too little control engage in behaviours to regain control

3 Traumatized youth may… have negative view of self Competency have negative view of self attribute failures to self expect rejection

ARC: A System-Based Approach to Trauma Attachment Routines & Rituals Caregiver Affect Management Attunement Consistent Response Self- Regulation Identification Modulation Expression Competency Executive Functioning Identity Trauma Integration

ARC: A System-Based Approach to Trauma 300+ agencies/child-serving systems U.S. and abroad adaptable/flexible promising practice by NCTSN & SAMHSA early research results promising

THANK YOU FOR YOUR ATTENTION & COLLABORATION! Canadian Association of Pediatric Health Centres webinar: Trauma-informed care: Youth sexual and non-sexual violence experiences and the ARC model: https://ken.caphc.org/xwiki/bin/view/CAPHC+Presents%21/Trauma-informed+Care%3A+Youth+Sexual+and+Non-Sexual+Violence+Experiences+and+the+Attachment%2C+Regulation%2C+and+Competence+%28ARC%29+model For more information about ARC: http://www.traumacenter.org/research/ascot.php Questions can be addressed to Delphine Collin-Vézina: delphine.collin-vézina@mcgill.ca