Resources for Developing Trauma-Informed Systems Diane M. Jacobstein, PhD Eileen Elias, M.Ed. November 19, 2015 NADD

© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Why all this increased focus on trauma? Our web-based tool for decision makers New resources Trauma and IDD Safety without Seclusion and Restraint Trauma Toolkit on IDD National Child Traumatic Stress Network Q & A Agenda

© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Higher Incidence of Abuse With any disability Sobsey, 1996; Westat, Inc., 1993; Goldson, to 2 times more likely to suffer from maltreatment than their nondisabled peers 3 to 4 times more likely to be neglected 4 times more likely to be the victims of crime 1.2 to 2 times more likely to suffer from maltreatment than their nondisabled peers 3 to 4 times more likely to be neglected 4 times more likely to be the victims of crime From Brian Tallant, LPC Aurora MH Center, December 2014

© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Higher incidence of abuse with DD People with developmental disabilities suffer 2.5 to 10 times the abuse and neglect of non-disabled peers More than 90% of adults reported sexual abuse within their lifetime 49% in sample reported 10 or more abusive incidents People with developmental disabilities suffer 2.5 to 10 times the abuse and neglect of non-disabled peers More than 90% of adults reported sexual abuse within their lifetime 49% in sample reported 10 or more abusive incidents Valenti-Hein & Schwartz,1995 From Brian Tallant, LPC Aurora MH Center, December 2014

© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Important to know: 6 From Brian Tallant, LPC Aurora MH Center, December 2014 In spite of high incidence, reported to police far less frequently than for general population More likely to happen in institutional setting (sexual abuse) Severity and duration of abuse more severe with more than one disability, more severe disability Vicious “two-way street” relationship between abuse and disability In spite of high incidence, reported to police far less frequently than for general population More likely to happen in institutional setting (sexual abuse) Severity and duration of abuse more severe with more than one disability, more severe disability Vicious “two-way street” relationship between abuse and disability

© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Trauma is pervasive At the heart of many or most behavioral crises and episodes of distress “Big T Trauma” and “Little t trauma” 7

Trauma Informed Care: Perspectives & Resources

9 Introductory Videos 8 Modules Partnership with JBS International LINKS TO THE TOOL: or

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

© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Over 182,000 views 103 Countries Most views in US, Canada, and Australia 11

© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Trauma Informed Care: Perspectives and Resources 12

odule2.html 13

© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Organization or system that is trauma-informed 14 Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) Rockville, MD: Substance Abuse and Mental Health Services Administration, Realizes the widespread impact of trauma Recognizes the signs and symptoms of trauma in both people we serve and staff Responds with policies, procedures, and practices Resist re-traumatization

© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Safety: Physical and Emotional Trustworthiness & Transparency Empowerment, Voice & Choice Collaboration and Mutuality Cultural, Historical, and Gender Issues Peer Support Trauma Informed Principles 15

© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY routinely screen culturally appropriate assessment and treatment resources available resilience and protective factors caregiver trauma continuity of care and collaboration across systems environment of support for staff Activities Included in Trauma Informed Systems and Organizations * Modified from NCTSN 7 Domains

© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Trauma- Informed: policies, procedures, and practices that promote an environment that addresses trauma and promotes a culture of hope & healing for staff and those served. Trauma Specific: treatment that specifically addresses trauma impact and symptoms Trauma-Informed vs. Trauma Specific 17

© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Secondary traumatic stress Could be either a one time event or be ongoing Could also be policies that inadvertently put pressure on staff Trauma-informed agencies address staff stress 18

Example of Savings at Grafton in Virginia Since Introducing Trauma-Informed Care 19

20 Safety without Seclusion and Restraint

© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY 21 Examples of resources on the website

© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Identifying and Addressing Secondary Traumatic Stress 22 This book is written for anyone who is exposed to the hardship, pain, crisis, trauma, or suffering of others who notice that they are not the same people they once were, or are being told by their families, friends, colleagues, or pets that something is different about them. The book provides suggestions for approaching the work in ways that produce positive outcomes for the helping people and for those they serve.

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© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY 24

© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Excellent Resources by Van der Kolk and Perry 25

© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Excellent Resource for Learning More 26 Organizational trauma is pervasive across nonprofit organizations, government agencies, and businesses. However, the phenomenon has received scant attention or been misidentified. Much work on organizational trauma ignores the systemic nature of traumatization and the insidious, negative consequences to organizations once trauma becomes embedded in organizational culture. Written for organizational leaders, consultants, and other practitioners interested in helping organizations become stronger, it gives them concepts and tools to strengthen their organizations and to help the organizations to heal from organizational trauma.

© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY NCTSN Toolkit: Trauma and IDD Release date November

© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Eileen Elias Diane Jacobstein Sherry Peters 28

© 2014 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Q and A 29