Trauma-Informed Care: Perspectives and Resources Federation of Families Conference November 22, 2014 Sherry Peters, MSW, ACSW Senior Policy Associate National Technical Assistance Center for Children’s Mental Health Sharon LeGore Founder and President MOMSTELL, Inc.

Objectives Provide background and history of the free on-line trauma-informed care resource tool Provide an interactive overview of the tool Preview sections of video interviews Provide information on trauma-informed care such as: What is trauma and trauma-informed care? Adverse Childhood Experience (ACE) Study and Resiliency Family and Youth Perspective

Introductory Video to the Tool

9 Introductory Videos 8 Modules LINKS TO THE TOOL: http://gucchdtacenter.georgetown.edu/TraumaInformedCare/ or http://trauma.jbsinternational.com/traumatool Partnership with JBS International 9 Introductory Videos 8 Modules

Other Summary Documents 5 Issue Briefs 7 Sets of Annotated Resources Example of video from Module 1: Understanding the Impact of Trauma 25 Content Videos

Youth and Family Perspectives http://gucchdtacenter.georgetown.edu/TraumaInformedCare/Module6.html Mariola will play youth and family video clip.

What is Trauma? Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014. http://store.samhsa.gov/product/SMA14-4884?from=carousel&position=4&date=09032014

What Does it Mean to be Trauma-Informed? Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.

Principles of a Trauma-Informed Approach Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.

Guidance for a Trauma-Informed Approach Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.

Definition of Trauma-Informed Child- and Family-Service System A trauma-informed child- and family-service system is one in which all parties involved recognize and respond to the impact of traumatic stress on those who have contact with the system including children, caregivers, and service providers. Programs and agencies within such a system infuse and sustain trauma awareness, knowledge, and skills into their organizational cultures, practices, and policies. They act in collaboration with all those who are involved with the child, using the best available science, to facilitate and support the recovery and resiliency of the child and family.     Source: National Child Traumatic Stress Network. Retrieved from http://www.nctsn.org/resources/topics/creating-trauma-informed-systems

Definition of Trauma-Informed Child- and Family-Service System, Continued A service system with a trauma-informed perspective is one in which programs, agencies, and service providers: routinely screen for trauma exposure and related symptoms; use culturally appropriate evidence-based assessment and treatment for traumatic stress and associated mental health symptoms; make resources available to children, families, and providers on trauma exposure, its impact, and treatment; engage in efforts to strengthen the resilience and protective factors of children and families impacted by and vulnerable to trauma; address parent and caregiver trauma and its impact on the family system; emphasize continuity of care and collaboration across child-service systems; and maintain an environment of care for staff that addresses, minimizes, and treats secondary traumatic stress, and that increases staff resilience.

Essential Elements of a Trauma-Informed Child Welfare System

Multi-Tiered Approach to Trauma-Informed Care in Schools e.g.TF-CBT e.g. CBITS e.g. screening, attention to transitions, calming activities

Adverse Childhood Experience (ACE) Study One of the largest investigations ever conducted to assess associations between childhood maltreatment and later-life health and well-being. Collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente's Health Appraisal Clinic in San Diego.

ACE Study Continued Initial phase 1995 to 1997 More than 17,000 participants completed a standardized physical examination and completed a confidential survey that contained questions about childhood maltreatment and family dysfunction, as well as items detailing their current health status and behaviors No further participants were enrolled, but medical status of the baseline participants tracked over time.

10 Adverse Childhood Experiences Studied Childhood abuse Emotional Physical Sexual Neglect Household Situations: Parental separation or divorce Household substance abuse Household mental illness Mother treated violently Incarcerated household member http://www.cdc.gov/ace/prevalence.htm#ACED

Adverse Childhood Experiences are Common

Antidepressant Prescriptions

Suicide Attempts

Adult Alcoholism

Teen Sexual Behaviors

Consequences of Lifetime Exposure to Violence and Abuse

More information about Finding Your ACE Score and Resiliency Score http://acestoohigh.com/got-your-ace-score/

What is your ACE Score What is your total ACE Score? __ 0 __ 6 Worksheet to calculate ACE Score __ 0 __ 6 __ 1 __ 7 __ 2 __ 8 __ 3 __ 9 __ 4 __ 10 __ 5 POLLING QUESTION (multiple choice with one response)

What Is Your Resilience Score? Developed by the early childhood service providers, pediatricians, psychologists, and health advocates of Southern Kennebec Healthy Start, Augusta, Maine, in 2006 and updated in February 2013. Mark Rains and Kate McClinn created the 14 statements with suggestions from members of the group. Scoring system was modeled after the ACE Study questions. Content based on research studies over 40 years including Emmy Werner Purpose is limited to parenting education - not developed for research.

Self-Care Resources http://gucchdtacenter.georgetown.edu/TraumaInformedCare/Module3Resources.html#Self-Care Screen shot of resources

Importance of Peer Support

Importance of Culture

Importance of Youth and Family Voice and What Helps

Addressing the Whole Family

Why Is it Important To Do This Work? Video clip from interview with Sandra Bloom about Healing