1. Trauma- Informed Parenting Dorothy Denny, MSW, LCSW

2. Our Objectives:  1. Participants will recognize essential elements in trauma-informed parenting.  2. Participants will consider possible caregiver reactions to disclosed trauma.  3. Participants will learn specific strategies designed to increase caregiver/s’ ability to respond appropriately and supportively to a child’s difficulties following a trauma disclosure.

3. 1. Recognize the impact trauma has had on your child. 2. Help your child to feel safe. 3. Help your child to understand and manage overwhelming emotions. 4. Help your child to understand and modify problem behaviors. 5. Respect and support positive, stable, and enduring relationships in the life of your child. 6. Help your child to develop a strength-based understanding of his or her life story. 7. Be an advocate for your child. 8. Promote and support trauma-focused assessment and treatment for your child. 9. Take care of yourself. 3 The Essential Elements of Trauma-Informed Parenting

4. Recognize the impact trauma has had on your child.  Internal Alarm Systems  Experience Grows the Brain  Developmental Derailment  The Invisible Suitcase

5. How Trauma-Informed Parents Can Respond  Offer a secure base of love and protection.  Be emotionally and physically available.  Recognize and respond to the child’s needs.  Provide guidance and example.  Provide opportunities to safely explore the world.

6. Help your child feel safe.  Promote Safety  Give a safety message  Explain rules  Be an emotional container  Manage emotional hotspots  Identify trauma reminders

7. Help your child to understand and manage overwhelming emotions.  Tune in to your child’s emotions.  Set an example.  Encourage positive emotional expression and behaviors.  Correct negative behaviors and inappropriate or destructive emotional expression, and help your child build new behaviors and emotional skills.

8. Help your child to understand and modify problem behaviors.  What are the negative effects of this behavior on your child’s life?  How can you help your child to understand these effects?  What alternatives can you suggest for this behavior?  What consequences can you set if the behavior continues?

9. Respect and support positive, stable, and enduring relationships in the life of your child.  Children are often able to take or make something good out of the bad  Community connections are broad

10. Help your child develop a strength-based understanding of his or her life story.  Make it safe to talk  Expect the unexpected.  Be aware of your reactions.  Don’t make assumptions.  Use active listening, and wise responding

11. Be an advocate for your child.  Know the team  Help others to understand trauma’s impact  Promote the importance of psychological safety.  Share strategies.  Help others to appreciate your child’s strengths and resilience.

12. Promote and support trauma- focused assessment and treatment for your child.  Know when your child needs help  Understand the basics of trauma- informed therapy  Learn why trauma-focused assessment is important  Ask questions if you are not sure that the therapy is working

13. Take care of yourself.  Sleep  Healthy diet  Taking a break  Exercise  Laughter  Self-expression  Let someone care for you

14. Caregiver Reactions  This is all easier said than done. What have you found actually happens after a child’s trauma disclosure?

15. Strength Reflections from our Victim Advocates  Praising the child for telling:  “Thank you for telling me.”  “I’m so glad you told.”  “I’m going to take care of this.”  “I believe them, I just don’t want to believe it happened.”

16. Red Flag Reflections from our Victim Advocates  “Why didn’t you tell me?!?”  “It couldn’t have happened because he’s never alone with my kids.”  Confronting the perpetrator with the child  Comparing their child’s experience to their own abuse experience  “The hospital said they weren’t messed with.”  “They’re fine, they never talk about it anymore.”  Demonstrating guilt

17. Why are we concerned?  Impediments to the forensic investigation  Recantation (Malloy, Lyon, & Quas, 2007)  Prosecutors drop case due to child sounding confused, inconsistent, or unconvincing  Diminished access to client by prosecutorial team

18. Why else are we concerned?  Clinical treatment implications  Hostile parenting is linked to acute symptomatology (Goslin et al, 2013)  Treatment engagement  Meaning making after trauma  Family communication  Future safety

19. So how do we help?  Teach in parent-friendly ways  Directly coach reactions  Maintain empathy, humility, and curiosity  Modeling/Parallel Process

20. Modeling the Elements  Recognize the impact trauma has had on their family.  “Traumatic experiences affect the family and broader caregiving systems” (NCTSN, 2012)

21. Modeling the Elements  Help the family feel safe.  Assess and address physical safety  Phone outreach anecdotal evidence  System advocacy and explanations  Use previous assessment information as possible

22. Modeling the Elements  Help the caregiver understand and manage overwhelming emotions.  Becoming their container.  The power of normalization.

23. Modeling the Elements  Help the caregiver understand and modify problem behaviors.  Help them understand the purpose so they can help the process.  Identify triggers they may control  Find out what is working.

24. Modeling the Elements  Respect and support positive, stable, and enduring relationships in the life of the family.  Core Concept 7: “Protective and promotive factors can reduce the adverse impact of trauma.” (NCTSN, 2012)

25. Modeling the Elements  Help the caregiver develop a strength- based understanding of his or her child’s life story and their parenting role.  Responding to the stated and unstated questions.

26. Modeling the Elements  Be an advocate for the family.  The importance of case management  The importance of the Multi-Disciplinary Team

27. Modeling the Elements  Promote and support trauma-focused assessment and treatment for the family.  Child and Family Traumatic Stress Intervention (CFTSI)  Trauma-Focused Cognitive Behavior Therapy (TF-CBT)  Child Parent Psychotherapy (CPP)  Cognitive Behavioral Intervention for Trauma in Schools (CBITS)  And more! http://www.nctsn.org/resources/topics/treatme nts-that-work/promising-practices http://www.nctsn.org/resources/topics/treatme nts-that-work/promising-practices

28. Modeling the elements  Take care of yourself.  Core Concept 12: “Working with trauma- exposed children can evoke distress in providers that makes it more difficult for them to provide good care.”  “That which gives light must endure…”

29. Resources  Berkowitz, S., & Marans, S. (2010). The Child and Family Traumatic Stress Intervention (CFTSI), a secondary prevention model for children exposed to a potentially traumatic event: Manual for providers (version 6). The Yale Child Study Center's Childhood Violent Traumatic Center of the National Traumatic Stress Network and The National Center for Children Exposed to Violence.  Goslin, M. C., Stover, C.S., Berkowitz, S., & Marans, S. (2013). Identifying youth at risk for difficulties following a traumatic event: Pre-event factors are associated with acute symptomatology. Journal of Traumatic Stress, 26, 475-482.  Grillo, C. A., Lott, D.A., Foster Care Subcommittee of the Child Welfare Committee, National Child Traumatic Stress Network. (2010). Caring for children who have experienced trauma: A workshop for resource parents—Facilitator’s guide. Los Angeles, CA & Durham, NC: National Center for Child Traumatic Stress  Malloy, L.C., Lyon, T.D., Quas, J.A.. (2007). Filial Dependency and Recantation of Child Sexual Abuse Allegations. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 162-170.  NCTSN Core Curriculum on Childhood Trauma Task Force (2012). The 12 core concepts: Concepts for understanding traumatic stress responses in children and families. Core Curriculum on Childhood Trauma. Los Angeles, CA, and Durham, NC: UCLA-Duke University National Center for Child Traumatic Stress.