1. Trauma-Informed Youth Programming
STYA Provider days
9/22 & 23, 2016

2. Objectives Trauma and its impact on youth Strategies to address trauma
What can PYD offer to work with youth living with trauma?

3. What is Trauma?
Acute
Chronic

4. Defining Trauma
Trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional or spiritual well-being.
SAMHSA 2014
Ask what type of events

5. Stress Response Increased: Fight, flight, freeze response
Hypervigilance, arousal, paranoia
Perceptual and information processing distortions
Pain tolerance
Emotional blunting
Aggression and irritability
Decreased:
Memory processing and retrieval
Reality testing
Body and emotional awareness
Immune response

6. Post Traumatic Stress Disorder (PTSD)
Symptoms last longer than a month after event
Intrusive re-experiencing of the trauma, avoiding trauma reminders (triggers), and persistent state of alert
Related emotional and behavioral problems
Co-occurs with other disorders (anxiety, ADHD, oppositional defiant disorder, etc.)
Symptoms vary according to developmental stages
Estimated prevalence: 3.5% of adults, less for children and youth
In adolescence
Flashbacks
Persistent re-experiencing of event (sometimes through risk-taking behavior)
Physical symptoms
Increased arousal/hyper-vigilance
Failure or regression in academic skills; concentration problems
Impulsive or aggressive behaviors
Absence of future planning

7. Re-Traumatization
A situation, attitude, interaction, or environment that replicates the events or dynamics of the original trauma and triggers the overwhelming feelings and reactions associated with them
Sample Triggers:
- Touch, sounds, gestures, light, opening a door without knocking

8. Adverse Childhood Experience (ACE)
Collaboration between Kaiser Permanente of San Diego and Centers for Disease Control and Prevention (CDC).
Initial phase conducted from in two waves.
Participants were given a standardized physical exam and completed a confidential survey on child maltreatment, family dysfunction, current health status and behaviors.
Each event received numeric value 1 – not weighted by severity
Unique opportunity to examine the relationships between a broad range of adverse childhood experiences (ACEs) and a wide range of health and social consequences in adulthood.

9. Adverse Childhood Experiences
Physical abuse by a parent
Emotional abuse by a parent
Sexual abuse by anyone
Growing up with an alcohol and/or drug abuser in the household
Domestic violence
Experiencing the incarceration of a household member
Living with a family member experiencing mental illness
Loss of a parent
Emotional neglect
Physical neglect
Trainer: Adverse Childhood Experiences (ACEs) can fall under three categories; abuse, neglect, or loss and occur prior to the age of 18. Any one of these events can have an impact on an individual. In combination, the greater the number of these events experienced the greater the cause for concern for an individual’s well-being.

10. More widespread than assumed
ACEs Study Findings
63% of study participants had experienced at least one category of childhood trauma.
Over 20% experienced 3 or more categories of trauma
4 or more traumatic experiences greatly increased adults’ risk for alcoholism, drug abuse, suicide attempts, sexually transmitted diseases, and poor general health.
4 or more ACEs:
15% of women % of men
The ACE study found that the presence of four or more serious adverse
experiences during childhood greatly increased adults’
risk for alcoholism, drug abuse, suicide attempts, sexually transmitted diseases,
and poor general health.
More widespread than assumed
Education
Not High School Graduate
7.2%
High School Graduate
17.6%
Some College
35.9%
College Graduate or Higher
39.3%

11. How many ACEs did you experience?

12. Effects of Trauma Behavioral Effects Cognitive Effects Social Effects
- Risk taking
- Acting out
- Rule breaking
Attention
Memory
Executive functions
Verbal abilities
Skills development
Language
Group work
Problem solve
Transition
Impulsivity
Aggression
Deviance
Withdrawal
Challenged relationships
What do they internalize?
People will hurt me
I’m helpless to prevent bad things from happening
I’m defective
I don’t matter
I’m helpless
I’m worthless
I can’t trust anyone
You will hurt me

13. Good News: Brain Plasticity
The brain has a powerful ability to change, adapt, and rewire itself throughout life.
Individual neurons grow, and new ones are added to the active circuits
It changes how it uses its genetic code, in response to life experiences
Stimulation, nutrition, exercise, stress, all modify this growth rate of neurons
The Developing Brain: Implications for Youth Program. 2014
series/

14. Good News: Resilience Environmental Protective Factors
Internal Protective Factors
Environmental Protective Factors
Social Competence
Problem Solving Skills
Autonomy
Sense of purpose, belief in a bright future
Caring Relationships
High Expectations
Opportunities for participation

15. Trauma-Informed Approach
“A program, organization, or system that is trauma-informed:
Realizes the widespread impact of trauma and understands potential paths for recovery;
Recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system;
Responds by fully integrating knowledge about trauma into policies, procedures, and practices; and
Seeks to actively resist re-traumatization."

16. Cultural, historical, and gender issues
Guiding Principles
Safety
Trustworthiness
Choice
Collaboration
Empowerment
SAMHSA
Cultural, historical, and gender issues
Safety includes physical and emotional safety of service space; are all staff members attentive to signs of consumer discomfort and do they recognize these signs in a trauma informed way?
Trustworthiness includes providing clear information/being transparent about what will be done, by whom, when, why and under what circumstances; respectful and professional boundaries; is unnecessary consumer disappointment avoided; is informed consent taken seriously on a consistent basis
Choice includes how much choice consumers have over the services they receive (such as time of day, gender preferences for service providers, etc.); are consumers provided a clear and appropriate message about their rights and responsibilities
Collaboration – true partnering and meaningful decision making; cultivating an atmosphere of doing “with” rather than doing “to” or “for”; conveying the message that the consumer is the expert in their own life?
Empowerment includes recognizing and validating consumer strengths and skills; building a realistic sense of hope for the client’s future; involving consumers in planning
SAMHSA adds
Cultural, historical, and gender issues - The organization actively moves past cultural stereotypes and biases (e.g., based on race, ethnicity, sexual orientation, age, geography), offers gender responsive services, leverages the healing value of traditional cultural connections, and recognizes and addresses historical trauma. ((
Fallot and Harris. 2006

17. How do you implement these guiding principles in your setting?

18. Principles Align with PYD
Family
Community
Peers
Supports
Services
YOUTH
Agencies
Services: those undertakings done ­to or for youth intended to enhance health, safety, performance, and other forms of essential well being and physiological functioning. These are the traditional primary, secondary, and, to some extent, tertiary intervention services provided by public health systems, school districts and recreational projects / facilities. These are critical but when they stand alone are inadequate for fostering well being.
Supports: Include tangible resources that are done with young people that facilitate access to interpersonal relationships and resources. Pittman et al. identify three main categories of support: emotional, motivational, and strategic – all of which work separately and together to foster positive development. Taken as a whole, supports promote a positive climate within which development occurs. Emotional support facilitates a sense of safety, nurturing and friendship. Motivational support provides positive expectations, guidance and developmentally appropriate boundaries. Strategic support facilitates access to needed resources and information.
Opportunities: These are things done by young people. It is within the realm of opportunities that youth become actors rather than recipients. The “O” in the SOS trilogy represents the extent to which youth are provided meaningful and real opportunities to practice and expand on what they know and learn – either through work, service, or advanced learning. Although youth ideally encounter a diverse array of different types of opportunities, not all opportunities are created equal. Those which are sustained and in which youth are encouraged to exercise meaningful decision making roles ultimately demand and foster the greatest number of competencies in young people.
Most px approaches focus on service with varying emphasis on support. YD approaches seek to assure that all youth are getting doses of all three at any given time. Not all orgs need to provide all three, but, to whatever degree they ca, it is very helpful.
Serving
Opportunities
School
Youth

19. Features of Positive Developmental Settings
Physical and Psychological Safety
Appropriate Structures
Supportive Relationships
Opportunities to Belong
Positive Social Norms
Support for Efficacy and Mattering
Opportunities for Skill Building
Integration of Family, School and Community Efforts
National Research Council (2002)
Physical and emotional safety of settings/environments
Appropriate structures aligns somewhat with the guiding principle of transparency – clear rules and expectations, clear boundaries and limit setting, predictability/schedules, age appropriate monitoring

20. Be Pro-Active Offer safe and supportive environment
Nurture resiliencies/strengths/ empowerment
Give young people choices/voice (youth-centered)
Provide opportunities to learn and practice skills (life skills)
How does TIC and its guiding principles align with PYD?
As TIC PYD is not focused on deficits, but is proactive - building positive outcomes using a strength based approach
Young people are at the center; young people are engaged as partners, having choices and making decisions
It nurtures and builds on young people’s strengths which empowers them to be engaged, making decisions for themselves and others
It provides youth with opportunities to develop critical like skills
Recognizes the importance of creating safe and supportive settings and environments

21. SEL Core Competencies Manage emotions Recognize one’s emotions,
and behaviors
to achieve
one’s goals
Recognize one’s emotions,
values, strengths, and
limitations
Make ethical,
constructive choices
about personal and
social behavior
Show
understanding
and empathy for
others
Form positive
relationships, work
in teams, deal effectively
with conflict

22. How do you respond to disruptive behavior?

23. Show and tell

24. Resources
ACT for Youth: Positive Youth Development ACT for Youth: Youth Work Professionals SAMHSA’s Concept of Trauma and Guidance for a Trauma- Informed Approach CDC: Adverse Childhood Experiences Study
Trauma Informed Community Initiative of WNY

25. Resources Ted Talk: Nadine Burke Harris
lth_across_a_lifetime?language=en
The Truth About ACEs (infographic)
ACES too High
National Child Traumatic Stress Network