6. SANCTUARY Organizational Change Based on Safety for both those who receive services and those who provide them

7. Understanding Trauma Core Commitments SELF Toolkit

8. TRAUMA CopingAdversity EventsExposureStressLow ResourceSkillsSupports

9. SANCTUARY BELIEFS #1 Adversity is Universal

10. SANCTUARY BELIEFS #2 What’s Happened?

11. So Why All the Fuss About Childhood Trauma???

12. A collaborative effort of Kaiser Permanente and The Centers for Disease Control Vincent J. Felitti, M.D. Robert F. Anda, M.D.

13. Purpose: Examine the health and social effects of adverse childhood experiences over the lifespan

14. Subjects: – 18,000 participants – Aged 50 or older (62%) – White (77%) – Had attended college (72%)

15. Abuse : psychological, physical, sexual Household Dysfunction: substance abuse, mental illness, domestic violence, separation from parents, incarceration

16. Scope of ACES Exposure + ACES as predictive of health risks/disease = ACEs the leading determinant of the health and social well-being in the US

18. So…. Childhood Adversity is a Critical Public Health Issue… and Nobody is Talking About It

20. Looking through a different lens

21. “ She just can’t make any friends. Nobody likes her !”  Poor social skills  Difficulty in relationships  Poor social skills  Difficulty in relationships

22. Trauma causes disrupted attachments Survival: If loving and trusting leads to pain, don’t do it! Trauma bonding is the other side of the coin

23. “This kid can’t sit still!”  Hyperactivity  Fidgeting  Constant Movement  Hyperactivity  Fidgeting  Constant Movement

24. Trauma causes hypervigilance Traumatized people are always on the lookout for danger

25. “It’s like a tornado hits wherever she goes!”  Causing chaos  Provoking others  Causing chaos  Provoking others

26. Trauma results in addiction to endorphins Survival: Adrenaline kicks in to give us extra strength and speed

27. “This kid is really going to hurt someone!”  Aggression

28. Trauma causes fight or flight Survival: The most basic human instinct

29. “She is a pathological liar!”  Stories don’t make sense  Not a very good liar – gets caught a lot!  Stories don’t make sense  Not a very good liar – gets caught a lot!

30. Trauma causes gaps in memory known as DISSOCIATION. Survival: We need things to make sense. When we are missing pieces, we fill them in.

31. Example:

32.  Hair-trigger temper

33. Trauma results in flashbacks Survival: Traumatic memory gets stored in a different part of our brains, and even in our bodies.

34. So, if Traumatic Stress has Such an Adverse Impact on the Kids We Serve… What’s it Doing to Me and the Place I Work?

35. The Organization is a Living, Growing, Changing System with Its Own Unique Biology…It is Every Bit as Susceptible to Stress, Strain & Trauma as the Individuals Who Live and Work in the Organization

36. Parallel Symptoms Hypersensitivity to even minor threat Extremist thinking Aggression and impulse control Attention to threat while ignoring less threatening, but important information

37. Parallel Process! Our systems frequently replicate the very experiences that have proven to be so toxic for the people we are supposed to treat.

38. Parallel Process Community Organization Staff Children & Families Fiscal pressures Social expectations Regulatory responsibilities

39. Parallel Process Community Organization Staff Children & Families Crisis Driven Fragmented Helpless Aggressive Stuck Hopeless Crisis Driven Fragmented Helpless Aggressive Stuck Hopeless : Loss of meaning

41. Address the Culture!! We Cannot Hope to Change the Lives of Children, If We Cannot Change the Environments in Which Care and Intervention Takes Place

42. Promotes and supports positive change in the children, their families and ourselves? Maximizes each other’s strengths and minimizes each other’s weaknesses? Buffers us from the impact of repetitive stress?