Trauma-Informed Services for Homeless Students: How our Community is Reaching out and Changing Lives Jean West MSW LCSW CTC-S School Social Worker Saint Joseph School District Missouri

Divorce may be more traumatizing than suicide or incarceration. Any experience that leaves a person feeling hopeless, helpless, fearing for their life/survival, their safety. Important to remember – it is a person’s perception, their experience not ours that makes something traumatic. Divorce may be more traumatizing than suicide or incarceration.

What Can Lead to Trauma What experiences could someone go through that could possibly be traumatizing?

Experiences which can cause trauma Physical and/or sexual abuse Domestic violence Living with substance abusing parents Witnessing parental homicide Homelessness Burns/other serious accidents Car fatalities Divorce Natural disasters

The Themes of Trauma Safety/Lack of safety Worry Hurt Fear Anger/Revenge Victim Thinking Loss of Future Orientation/Helplessness/Hopelessness

Trauma… Trauma means being “stuck” in the experience, unable to successfully face the emotional pain, cope with it, and go on with normal life

Trauma is… What has happened to you? NOT what is wrong with you!

How does Trauma Impact Behavior?

Traumas Effect on Behavior Hypervigilance Difficulty sleeping Easily startled Clinging Nightmares Disobedience Impaired social skills Anger /rage Can’t self sooth or modulate emotions Depression Attention problems Impulsivity Aggression Fearful Risk taking Panic attacks Hypersensitive to touch, movement, some sounds and smells

How does Trauma Impact Learning?

Traumas Effect on Learning In the arousal (anxious) state it becomes difficult to process information, follow directions, recall information, and focus Physician’s office Poor problem solving, attention, disorganized Often only hear half of the words spoken by their teachers Cognitively will generally be far behind their peers, children can often learn at three times the rate compared to when engulfed in trying to survive

The Role of the Brain and the Nervous System

How would you describe the taste of Apple Pie ?

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. The National Center for Trauma Informed Care 2012

Becoming Trauma Informed cont… Becoming trauma-informed is a process that involves striving towards a new way of understanding people and providing services and supports. This process involves a gradual integration of trauma concepts and trauma sensitive responses into daily practice.

Becoming Trauma Informed Understanding Trauma and Its Impact: Understanding traumatic stress and how it impacts people and recognizing that many behaviors and responses that maybe seem ineffective and unhealthy in the present, represent adaptive responses to past traumatic experiences.

Do we do this?

Trauma and Homelessness “Trauma- physical, sexual, and emotional –is both a cause and a consequence of homelessness.” HCH 1999

Impact of Homelessness on Children Every day, homeless children are confronted with stressful, often traumatic events. 74% of homeless children worry they will have no place to live. 58% worry they will have no place to sleep. 87% worry that something bad will happen to their family. (Impact on education, trauma) National Center on Family Homelessness 1999

Mental Health The constant barrage of stressful and traumatic experiences has profound effects on the cognitive and emotional development of homeless children. Homeless babies are four times more likely to show delayed development then non-homeless babies. Homeless children between 6 and 17 years struggle with very high rates of mental health problems. The National Center on Family Homelessness 2010

Teens Homeless youth exhibit psychiatric disorders at a rate six times greater than the general youth population, with between 66 and 89 percent of homeless youth having symptoms of one or more disorders. Whitbeck, 2009

Subgroups even more at risk Within the homeless youth population there are certain sub-groups who are the most at risk for developing a mental illness. Gay, lesbian, bi-sexual, and transgender youth appear to have the most pervasive mental health problems. Youth who have been in state care Youth who have histories of abuse. Whitbeck, 2009

The Emotional Impact More then one-fifth of homeless preschoolers have emotional problems serious enough to require professional care, but less then one-third receive any treatment. Homeless children have twice the rate of learning disabilities and three times the rate of emotional and behavioral problems as nonhomeless children. Half of school-age homeless children experience anxiety, depression, or withdrawal compared to 18% of nonhomeless children. By the time homeless children are eight years old, one in three has a major mental disorder. NCTSN 2005

Homeless Mothers

Violence The frequency of violence in the lives of homeless mothers is staggering. 63% have been violently abused by an intimate male partner. 27% have required medical treatment because of violence by an intimate male partner. 25% have been physically or sexually assaulted during adulthood by someone other than an intimate partner. 66% were violently abused by a childhood caretaker or other adult in the household before reaching 18. 43% were sexually molested as children. NCTSN 2005

Trauma and Homelessness Cont… Homelessness results in a loss of community, routines, possessions, privacy, and security. According to The National Traumatic Stress Network, more than 90% of sheltered and low-income mothers have experienced physical and sexual assault over their lifespan. The experience of homelessness puts families in situations where they are at greater risk of additional traumatic experiences such as assault, witnessing violence, or abrupt separation. The stresses associated with homelessness can exacerbate other trauma-related difficulties and interfere with recovery due to ongoing traumatic reminders and challenges. NCTSN 2005

Trauma and Homelessness Cont… Trauma is THE predominant mental health issue for homeless mothers. Research confirms that the strongest predictor of emotional and behavioral problems in poor and homeless children is their mother’s level of emotional distress. HCH 2003 (resiliency research with TLC) Emotional help is needed for both the parents and their children in order to be most effective.

SITCAP The National Institute for Trauma and Loss in Children www.starrtraining.org/tlc

Sensory Based 8 week programs What Color is your Hurt? TIP Trauma Intervention Program Certification Process

Draw me a Picture…

8 year old female

Data 97% of the students participating in the SITCAP program showed a reduction in each subcategory of PTSD symptoms upon completion of the program. Re-experiencing Avoidance Arousal

Hurt/Anger – Tear a Shape

Importance in Assessment Process Programs serving families who are experiencing homelessness have an opportunity to address children’s needs and connect them to appropriate services. To meet children’s needs, questions about their exposure to trauma must be included in the intake assessment.

Research-Based Practices Workgroup Certification Website Trainings On-line courses Funding Sustainability Over 20 CTS Mentoring Research-Based Practices Workgroup McKinney Vento program School Counselors/Social Workers TLC COH

McKinney-Vento TLC COH SJSD Couns/SW Programs Shelter Trainings Staff Mentoring On-going Training SITCAP Workgroup Community Agencies Parent Trainings SITCAP Groups Individual work

Resources Cowan, Beryl Ann, "Trauma exposure and behavioral outcomes in sheltered homeless children: The moderating role of perceived social support" (2007). Psychology Dissertations. Paper 39. http://digitalarchive.gsu.edu/psych_diss/39 HCH Health Care for the homeless Clinician’s network. Trauma and Homelessness.(1999) Vol.3, No.3 HCH Health Care for the homeless clinician’s network. Homelessness and family trauma: The Case for early intervention. (2003) Vol. 7, No. 2 NCTIC The National Center for Trauma Informed Care NCTIC@NASMHPD.org NCTSN The National Child Traumatic Stress Network. Facts on Trauma and homeless children. (2005) www.NCTSNet.org Les Whitbeck, Mental Health and Emerging Adulthood Among Homeless Young People (New York: Psychology Press, 2009) 54, 75. The National Center on Family Homelessness 1999 www.familyhomelessness.org www.nhchc.org/ShelterHealth/ToolKitA/A2HomelessChildren.pdf

jean.west@sjsd.k12.mo.us