Students, Trauma, and Resiliency

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Presentation transcript:

Students, Trauma, and Resiliency Debra Klemann, M.S., LCPC

Presentation name location and date Established in Fall 2007 to serve as a Treatment and Services Adaptation Center (Cat II) within the National Child Traumatic Stress Network (NCTSN) Represents a national expansion of the previously funded Montana Center for Childhood Trauma (BOR approved, 2004) Mission: In respectful partnerships with tribes, NNCTC will implement, adapt, evaluate and disseminate trauma interventions to decrease the social, emotional, spiritual and educational impact traumatic experiences have on American Indian and Alaska Native children. Only center funded to work with AI/AN Network, New Orleans, LA etc. National Child Traumatic Stress Network Established by Congress in 2001 Presenter name and grant/center affiliation

What is Child Traumatic Stress? Traumatic Stress defined Traumatic stress is an acute distress response that is experienced after exposure to a catastrophic event Traumatic stress occurs because the event poses a serious threat to: The individual's life or physical integrity The life of a family member or close friend One's surrounding environment D

A range of situations that can be traumatic Automobile Accidents Life-Threatening illness Witnessing or experiencing community violence (shootings, stabbings, robbery, fighting at home, in the neighborhood, or at school) Natural Disasters Terrorism Traumatic death Physical or sexual abuse Abandonment Witnessing Domestic Violence Bullying Neglect Living in a chronically chaotic environment Military deployment Note the top half are those events that are more typical of one time incidents Bottom half examples of complex trauma

Complex Trauma/ Developmental Trauma Occurs through multiple & prolonged exposure to traumatic events that occur within the child’s care giving system. Includes chronic emotional abuse, neglect, sexual abuse, physical abuse and witnessing domestic violence. Alters body functioning Increased levels of stress hormones Increase in activity of the “reactive brain”. P The social environment that is supposed to be the source of safety and stability in a child’s life. Moreover the emotional dysregulation that accompanies the chronic abuse, loss of a safe base, loss of direction and inability to detect or respond to danger cues often lead to subsequent trauma exposure.

Responses to a Traumatic Event Hyperarousal Re-experiencing Avoidance or Numbing Changes in Affect Cognitive distortions D Hyper arousal-Child’s mind and body remain in a constant state of alert months after the danger has subsided. Hyper arousal can sometimes lead to generalized anxiety. Children often experience trauma triggers, an event, object, person, place, sight, sound, smell, send their bodies in overdrive. Left with feeling scared for no reason or out control, paranoia or impending doom. Classroom accommodations, like being able to see the entire class, or being placed next to a window, keeping the classroom door open. Because of the internal chaos it is important to help children feel safe by providing them with consistency and choices.

Presentation name location and date How Common is Trauma? 1 out of 4 children who attend school has been exposed to a traumatic event (NCTSN) Screening results of 6 communities indicate that upwards of 70% of students have been exposed to violence, and 47% experiencing PTSD like symptoms (Morsette, et. al 2012) 2/3 of interviewed children reported at least one trauma (Copland, et. al 2007) Associated with Violence, Citation from Dick? NCTSN website, lifetime exposure number at the website Presenter name and grant/center affiliation

Presentation name location and date Resilience Research has shown that 2/3 of children who experience adverse childhood events will grow up and “beat the odds”. Adolescents may be resilient in one area in their lives, but not in others Resiliency at one developmental phase does not guarantee resiliency at the next. Resilience should be viewed as “fluid over time.” Resilience declines with each event. Presenter name and grant/center affiliation

Trauma-informed Positive Behavioral Interventions and Supports Presentation name location and date FEW Trauma-informed Positive Behavioral Interventions and Supports SOME ALL Trauma-Informed Positive Behavior Supports Can’t prescribe one particular intervention….establish school environment that will enable traumatized children to develop positive relationships with caring adults, learn how to regulate their emotions and behaviors, and ultimately achieve at higher educational levels When schools have a better understanding of trauma they can form effective linkages with mental health professionals who have expertise in that field – advocate for resources/interventions for that child Presenter name and grant/center affiliation

Why Do Education Programs Need to Know About Trauma? Presentation name location and date Why Do Education Programs Need to Know About Trauma? When students experience trauma it affects Ability to learn Ability to make friends/social skills Behaviors in the classroom Teachers/care providers may be the first to notice symptoms Teachers/Systems can provide social/emotional curriculum and employ classroom strategies to help However we do not always know that a child has been traumatized – it can be difficult for educators to discern the reasons for a child’s behavioral and learning problems….why it’s important to consult with people who know about trauma…to have a behavior support team… Presenter name and grant/center affiliation

STAR Overview Curriculum based 4 lessons; 1 per week Based upon evidence based principles for treating trauma Designed for use by educators Not therapy, but psychoeducational Designed for use in the classroom Recommend use of co-facilitators Curriculum based-work in health, guidance, social studies settings Based upon cognitive behavioral therapy has proven to be quite effective in treating childhood trauma Not therapy, took out personal sharing as to decrease vulnerability and risk, but still advocate for the use of co-facilitators and school counselor support. Good to have extra eyes and ears tracking for possible signs of distress.

Goals of STAR Increase Coping Strategies Understanding of stress, trauma, and loss Self-care Relaxation Utilizing support systems Problem-Solving Helpful thoughts Feelings Identification Decrease effects of trauma exposure Feelings of isolation Anxiety level Avoidance Impulsivity Negative thinking Hypervigilance

Lesson #1: Education and Coping Strategies Objectives Provide education Validate experiences Help student recognize signs of stress Teach relaxation skills Encourage healthy coping skills Decrease isolation—it is not just me that has these experiences Lesson usually involves review practice between lessons and a review of practice/skills from the previous lesson at the start of the next lesson.

Lesson #1 Definitions of Stress Trauma Loss/Grief A physical, mental, or emotional strain or pressure Feeling anxious or overwhelmed Responses to difficult events-stressors Trauma Perception of something very frightening Sense of helplessness Loss/Grief Grief is the normal process of reacting to a loss Examples: loss of a loved one Pets Home environment Not all stress is negative, in fact it is a natural response to change and is useful in helping our bodies and minds respond to challenges, such as running a race, meeting new people, or trying something new. What are some situations that might be stressful. Next Loss: Trauma: You can experience the even or witness it happen to others, the trauma involves a feeling of immediate threat to one’s life or feelings of security. Feelings of intense fear or anxiety are evoked. Perception is what matters in determine if something is traumatic.

Lesson #1 Common reactions to stress, trauma, and Loss Stress effects the balance of our whole being   Physical, mental, emotional, spiritual Invite a guest speaker to describe the significance of the medicine wheel.

Lesson #2: Feelings and Thoughts Objectives Increase feelings identification Link thoughts and feelings Identify and challenge thinking errors Decrease impulsivity Practice incentives In order for students to learn to modulate their feelings, they first need some work in identifying and naming those feelings.

Lesson #2 Main family of emotions Increase feelings vocabulary Feelings Identification Main family of emotions Increase feelings vocabulary Identify degrees or ranges of emotion Feeling words handouts Degrees of emotions—why? So we don’t overreact to situations. Feelings identification—why? So we can express ourselves and communicate what we are feeling, many times better than acting the emotion out.

Lesson #2: Cognitive Behavioral Therapy(CBT) Model What we THINK How we FEEL What we DO Cognitive Behavioral Therapy(CBT) Model Langley and Dean 2004 Tell snowstorm story and Phillip story. Phillip is a boy who was jumped at the basketball courts at night. Know he thinks playing basketball is unsafe, he feels a lot of anxiety when thinking about he courts or playing basketball, and now he has withdrawn from his friends and does not want to shoot hoops with them anymore.

Unhelpful Helpful All or Nothing Nancy Check the facts Jumping Jim Downer Debbie Play it Again Sam Check the facts What are the other possibilities? Is there a more positive way of looking at this? What might be other outcomes?

Lesson #3: Facing Avoidance and Anxiety Objectives Explain avoidance Face and decrease anxiety

Is this plan safe? Yes, I am only going during the day with an adult Pyramid Plan 9-10 Anxiety Level: Play basketball with friends and my older cousin during the day. I may need to do this 10 times. CAUTION: Is this plan safe? Yes, I am only going during the day with an adult 6-8 Anxiety Level: Walk on to the courts with a group, including my adult cousin. I may need to do this 8 times. 4-5 Anxiety Level: Walk near the courts with my adult cousin. I may need to do this 5 times. Next ask students to work together to on scenarios to formulate pyramid plans. 1-3 Anxiety Level: Drive by the courts. I may need to do 3 times.

Lesson #4: Social Problem-Solving and Increasing Support Objectives Review activities Identify link between thoughts and behaviors Decrease impulsivity by identifying pros and cons of decisions Identify resources Identify circles of support

Lesson #4 Social Problem Solving Check the accuracy of thoughts before acting How do I know this is thought is true? How do I find out more information about what is happening? Why is it important to find this information out? Social Problem Solving The class identifies in small groups possible solutions to a situation Pros and Cons are identified for each behavior The small group decides as a group which behavior is most beneficial

Circle of Trust Me People very close to me Friends, family, and trusted adults Know how to help Listen well Do not repeat what I say to others Do not judge me People I know and spend time with People I feel good being around Might be able to trust them People who are acquaintances Role Models Community Leaders People I would like to get to know Circle of Trust Who would you tell if something traumatic, scary, or upsetting happened. If it is very personal we should be careful who will tell and maybe stick with the circle ring closest to us. Sometimes we have a lot of people in our circle, sometimes we have very few, sometimes we need to seek support form someone who has lots of experience listening and helping like a professional counselor, or clergy member.

Data Collection Screening of all students to identify Violence Exposure (LES) Trauma Symptoms (CPSS) Pre/Post Tests CPSS Why helpful Gain an understanding of students Identify progress

More Information STAR Training Technical Assistance debra.klemann@umontana.edu Links to resources www.nctsn.org http://www.iers.umt.edu